Diagnostic utility of CD10 in differentiating hepatocellular carcinoma from metastatic carcinoma in fine‐needle aspiration biopsy (FNAB) of the liver

Abstract

The differential diagnosis between hepatocellular carcinoma (HCC) and metastatic carcinoma, especially in moderate-poorly differentiated (MPD) HCC and poorly differentiated carcinoma, can be challenging in fine-needle aspiration biopsy (FNAB) of the liver. Recent studies demonstrate that canalicular staining for CD10 appears to be a highly specific marker for hepatocytic differentiation. The objective of this study was to test the utility of CD10 in differentiating HCC from metastatic carcinoma in FNAB of the liver. Formalin-fixed, paraffin-embedded cell blocks of 55 cases (22 HCC, 23 metastases, and 10 benign hepatic lesions) of FNAB of the liver were immunostained using monoclonal antibody against CD10, with microwave oven antigen retrieval, followed by a standard ABC method. Nineteen (86%) of 22 HCC cases were positive for CD10 with a canalicular staining pattern. Among them, 9 (82%) of 11 well-differentiated (WD) HCC and 10 (91%) of 11 MPD HCC were positive for CD10. Three (13%) of 23 metastatic carcinomas were positive for CD10, demonstrating a contrasting cytoplasmic and membranous staining pattern. The three positive cases were metastatic renal cell carcinoma (RCC), choriocarcinoma, and adenocarcinoma of the lung. All 10 cases of benign hepatic lesions showed positivity for CD10 with a canalicular and focal membranous staining pattern. In conclusion, CD10 appears to be a useful marker in discriminating between HCC and metastatic carcinoma when applied to FNAB of the liver. CD10 does not provide discrimination between WD HCC and benign hepatocytes.

HepPar1, MOC-31, pCEA, mCEA and CD10 for Distinguishing Hepatocellular Carcinoma vs. Metastatic Adenocarcinoma in Liver Fine Needle Aspirates

“…17 However, another study, performed on formalin-fixed FNAB cell blocks, showed canalicular staining of CD10 in 82% of 22 well-to moderately differentiated HCCs. 3 The sensitivity in our cases, most of which were also well to moderately differentiated, was far lower. In addition, CD10 staining pattern was cytoplasmic and membranous in 2 HCC cases; the problem has been reported in surgical specimens as well.…”

“…Although the cellular features of the specimen are still essential in the differential diagnosis between HCC and MA, application of immunomarkers has improved the diagnostic accuracy and is especially helpful in challenging cases. [1][2][3] In past decades, numerous antibodies have been suggested as useful in the distinction of HCC from…”

“…12,18,19 The application of these antibodies to FNAB cell block material, which is fixed and processed differently from tissue biopsies, has been less thoroughly tested. 1,3,13,20 In this study, we examined the utility of AFP, CD10, mCEA, pCEA, MOC 31 and HepPar1 in diagnosing HCC vs. MA on liver FNAB cell blocks. Previous studies on cytokeratin subtypes reported conflicting results, 7,9,10,21,22 and studies of B72.3 and factor XIIIa have failed to demonstrate their usefulness, 4,23 so these antibodies were not included in this study.…”

A Giant Primary Clear Cell Hepatocellular Carcinoma in a Young Woman without Cirrhosis

“…Hepar1 was strongly positive, and as reported by Murakata et al, this stain has 90% sensitivity and 100% specificity for establishing the liver as the origin of a clear cell cancer [12]. Moreover, CD10 staining in a canalicular pattern, not cytoplasmic/membranous-staining pattern seen in clear cell renal cell carcinoma, further supports that this mass is hepatic in origin [13]. Finally, positive glypican 3 and diffuse sinusoidal staining pattern of CD34 further established that this was a malignant primary liver tumor [14,15].…”

Occult hepatocellular carcinoma metastasising to the left temple diagnosed by fine-needle aspiration biopsy

“…14,15 Polyclonal carcinoembryonic antigen and CD10 demonstrate a cannalicular-staining pattern, whilst CD34 can highlight the vessels and the endothelialised sinusoids. [14][15][16] AFP is relatively specific but lacks sensitivity being positive in less than 50% of HCC. 14,15 Hepatocyte paraffin 1 (HepPar1) is a relatively new antibody that has high sensitivity and specificity for hepatocellular differentiation.…”