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Difference between revisions of "Liver neoplasms"
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(→Cholangiocarcinoma: more) |
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| CK7+, CK19+ | | CK7+, CK19+ | ||
| background usu. not cirrhotic | | background usu. not cirrhotic | ||
| [ | | [[Image:Cholangiocarcinoma.png|thumb|center|150px| Cholangiocarcinoma. (WC)] | ||
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*No cirrhosis! If cirrhosis is present it isn't a hepatic adenoma - '''important'''. | *No cirrhosis! If cirrhosis is present it isn't a hepatic adenoma - '''important'''. | ||
Images | ====Images==== | ||
<gallery> | |||
Image:Hepatic_adenoma_low_mag.jpg | Hepatic adenoma. (WC/Nephron) | |||
Image:Hepatic_adenoma_low_mag_reticulin.jpg | Hepatic adenoma - reticulin. (WC/Nephron) | |||
</gallery> | |||
www: | |||
*[http://www.ajronline.org/cgi/content-nw/full/182/6/1520/FIG3 Hepatic adenoma (ajronline.org)]. | *[http://www.ajronline.org/cgi/content-nw/full/182/6/1520/FIG3 Hepatic adenoma (ajronline.org)]. | ||
*[http://radiographics.rsna.org/content/22/5/1023.figures-only Series of liver micrographs including hepatic adenoma (radiographics.rsna.org)]. | *[http://radiographics.rsna.org/content/22/5/1023.figures-only Series of liver micrographs including hepatic adenoma (radiographics.rsna.org)]. | ||
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*[[Hepatocellular carcinoma]] - separated based on histomorphology alone. | *[[Hepatocellular carcinoma]] - separated based on histomorphology alone. | ||
Images | ====Images==== | ||
<gallery> | |||
Image:Hepatoblastoma_-_2_-_very_high_mag.jpg | Hepatoblastoma - very high mag. (WC/Nephron) | |||
Image:Hepatoblastoma_-_high_mag.jpg | Hepatoblastoma - high mag. (WC/Nephron) | |||
</gallery> | |||
====Subtypes==== | ====Subtypes==== | ||
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*Combined HCC-CC.<ref name=pmid21559202>{{Cite journal | last1 = Walther | first1 = Z. | last2 = Jain | first2 = D. | title = Molecular pathology of hepatic neoplasms: classification and clinical significance. | journal = Patholog Res Int | volume = 2011 | issue = | pages = 403929 | month = | year = 2011 | doi = 10.4061/2011/403929 | PMID = 21559202 | PMC = 3090128 }}</ref> | *Combined HCC-CC.<ref name=pmid21559202>{{Cite journal | last1 = Walther | first1 = Z. | last2 = Jain | first2 = D. | title = Molecular pathology of hepatic neoplasms: classification and clinical significance. | journal = Patholog Res Int | volume = 2011 | issue = | pages = 403929 | month = | year = 2011 | doi = 10.4061/2011/403929 | PMID = 21559202 | PMC = 3090128 }}</ref> | ||
Images | ====Images==== | ||
<gallery> | |||
Image:Hepatocellular_carcinoma_low_mag.jpg | HCC - low mag. (WC) | |||
Image:Hepatocellular_carcinoma_intermed_mag.jpg | HCC - intermed mag. (WC) | |||
</gallery> | |||
====Fibrolamellar hepatocellular carcinoma==== | ====Fibrolamellar hepatocellular carcinoma==== | ||
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*If ''conventional HCC'' is seen focally within the tumour, it is ''conventional HCC''. | *If ''conventional HCC'' is seen focally within the tumour, it is ''conventional HCC''. | ||
Images | ======Images====== | ||
<gallery> | |||
Image:Fibrolamellar_hepatocellular_carcinoma_-2-_intermed_mag.jpg | FHCC - intermed. mag. (WC) | |||
Image:Fibrolamellar_hepatocellular_carcinoma_-2-_very_high_mag.jpg | FHCC - very high mag. (WC) | |||
</gallery> | |||
====Sclerosing HCC==== | ====Sclerosing HCC==== | ||
Features: | Features: | ||
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**May have satellite nodules. | **May have satellite nodules. | ||
Image | ====Image==== | ||
<gallery> | |||
Image:Cholangiocarcinoma.png | Cholangiocarcinoma. (WC) | |||
</gallery> | |||
===Microscopic=== | ===Microscopic=== | ||
Features:<ref name=Ref_GLP609>{{Ref GLP|609}}</ref> | Features:<ref name=Ref_GLP609>{{Ref GLP|609}}</ref> | ||
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**No necrosis, no mitotic activity, no significant [[nuclear pleomorphism]]. | **No necrosis, no mitotic activity, no significant [[nuclear pleomorphism]]. | ||
Images | ====Images==== | ||
<gallery> | |||
Image:Cholangiocarcinoma_-_low_mag.jpg | Cholangiocarcinoma - low mag. Shows the typical [[demosplastic stroma]]. (WC/Nephron) | |||
Image:Cholangiocarcinoma_-_high_mag.jpg |Cholangiocarcinoma - high mag. Shows a normal portal triad adjacent to atypical glandular cells within the interlobular septum and obvious tumour. (WC/Nephron) | |||
</gallery> | |||
www: | |||
*[http://path.upmc.edu/cases/case296.html Cholangiocarcinoma & liver flukes - several images (upmc.edu)]. | |||
*[http://path.upmc.edu/cases/case420.html Cholangiocarcinoma - several images (upmc.edu)]. | |||
===IHC=== | ===IHC=== | ||
| Line 563: | Line 572: | ||
*Gland forming columnar shaped cells with pseudostratified hyperchromatic cigar-shaped nuclei. | *Gland forming columnar shaped cells with pseudostratified hyperchromatic cigar-shaped nuclei. | ||
Image | ====Image==== | ||
<gallery> | |||
Image:Adenocarcinoma_liver_metastasis.jpg | Liver metastasis - adenocarcinoma, not obviously CRC (WC)]. | |||
</gallery> | |||
===IHC=== | ===IHC=== | ||