Neuroendocrine metastatic tumors of the liver resembling hepatocellular carcinoma

Arista-Nasr, Julián; Fernández-Amador, J.A.; Martínez‐Benitez, Braulio; Anda-González, Jazmín De; Bornstein-Quevedo, Leticia

doi:10.1016/s1665-2681(19)31660-6

Cited by 6 publications

(4 citation statements)

References 13 publications

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“…These neoplasms may show hepatocyte-like histology including large, granular and eosinophilic cytoplasm. Furthermore, nuclear features of neuroendocrine differentiation (e.g., salt and pepper nuclei) are not always evident, particularly in small samples (Arista-Nasr et al 2010). Clinical history of neuroendocrine deregulation (e.g., hormonal imbalances), absence of background liver disease and IHC for neuroendocrine markers including chromogranin A, synaptophysin and -Nasr et al 2010;Jin et al 2016;Sobotka et al 2019).…”

Section: Hepatocellular Carcinoma: Histologymentioning

confidence: 99%

“…Furthermore, nuclear features of neuroendocrine differentiation (e.g., salt and pepper nuclei) are not always evident, particularly in small samples (Arista-Nasr et al 2010). Clinical history of neuroendocrine deregulation (e.g., hormonal imbalances), absence of background liver disease and IHC for neuroendocrine markers including chromogranin A, synaptophysin and -Nasr et al 2010;Jin et al 2016;Sobotka et al 2019). Of note, these markers are also helpful in cases of combined hepatocellular and neuroendocrine carcinoma.…”

Section: Hepatocellular Carcinoma: Histologymentioning

confidence: 99%

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The strengths and weaknesses of gross and histopathological evaluation in hepatocellular carcinoma: a brief review

Martins-Filho

Alves

2019

Surg Exp Pathol

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Careful pathological analysis of hepatocellular carcinoma (HCC) specimens is essential for definitive diagnosis and patient prognostication. Tumor size and focality, gross patterns, macro-and microvascular invasion, degree of histological differentiation and expression of Keratin 19 (K19) are relevant features for risk stratification in this cancer and have been validated by multiple independent cohorts. However, there are important limitations to pathological analyses in HCC. First, liver biopsies are not recommended for diagnosis according to current clinical guidelines. Second, there is limited morphological data from patients at intermediate, advanced and terminal disease stages. Finally, there is little consensus on the evaluation of key histopathological features, notably histological grading (degree of differentiation). Here, we review important morphological aspects of HCC, provide insights to molecular events in relation to phenotypic findings and explore the current limitations to pathological analyses in this cancer.

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Section: Hepatocellular Carcinoma: Histologymentioning

confidence: 99%

Section: Hepatocellular Carcinoma: Histologymentioning

confidence: 99%

The strengths and weaknesses of gross and histopathological evaluation in hepatocellular carcinoma: a brief review

Martins-Filho

Alves

2019

Surg Exp Pathol

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“…Colorectal carcinoma represents the most common primary among liver metastasis; however, distinction from HCC or CC is usually not problematic since most colorectal carcinomas display a characteristic histomorphology and/or have a known primary. Neuroendocrine tumors (NETs), the second most common source of liver metastases [2,3], often pose challenges in the differential diagnosis because they can show trabecular, nested, and acinar histologic patterns that may be mistaken for HCC or CC.…”

Section: Introductionmentioning

confidence: 99%

Liver Metastases of Neuroendocrine Tumors Rarely Show Overlapping Immunoprofile with Hepatocellular Carcinomas

et al. 2016

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The distinction of hepatocellular carcinoma (HCC), neuroendocrine tumor (NET) metastatic to the liver, and cholangiocarcinoma (CC) can sometimes be challenging on small biopsies. Tissue microarrays were constructed from HCCs, NETs, and CCs. The immunoprofile was evaluated using HepPar1, glypican-3 (GPC3), synaptophysin (SYN), chromogranin A (CHR), CD56, MOC-31, and pCEA. One hundred thirteen HCCs, 48 NETs, and 44 CCs were included. Of HCCs, 107 (95 %) expressed HepPar1 and/or GPC3, 52 (46 %) both, and 97 (88 %) marked with pCEA (canalicular pattern). Seven (6 %) expressed CD56, of which 3 (3 %) expressed SYN. All 7 HCCs that expressed CD56 and/or SYN also expressed HepPar1 and/or GPC3, and none of the HCCs expressed CHR. Fourteen (13 %) expressed MOC-31. All 48 NETs expressed at least one neuroendocrine marker: 47 (98 %) positive for SYN, 40 (83 %) for CHR, 39 (81 %) for CD56, and 34 (71 %) for all three markers. None expressed HepPar1 or GPC3. All 44 CCs showed at least focal reactivity with MOC-31 and pCEA (membranous/cytoplasmic). One (2 %) was positive for HepPar1, 4 (9 %) for GPC3, 1 (2 %) for SYN and CHR, and 7 (16 %) for CD56. HCCs rarely express CD56 and SYN, while all express either HepPar1 or GPC3. NETs do not express HepPar1 or GPC3 and almost always express SYN, while CHR and CD56 are seen in most cases. Rare CCs focally express HepPar1 and GPC3. Utilizing a limited staining panel can efficiently distinguish HCCs, NETs, and CCs and help avoid diagnostic pitfalls on small biopsies.

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“…can also be found by other approaches such as liver dynamic CT or MRI. Several cases of NET were misdiagnosed as HCC after retrograde review[6]. Therefore, a diagnosis of metastatic NET in the liver must be presumed when plasmacytoid cells are intermingled with broad bands of connective tissue, or associated with delicate strands of fibrovascular tissue.…”

mentioning

confidence: 99%

Gastroenteropancreatic Neuroendocrine Tumor with Hepatic Metastasis Misdiagnosed as Hepatocellular Carcinoma

Kim¹,

Kim²,

Seo³

et al. 2019

Korean J Med

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The liver is the most common site of metastasis of neuroendocrine tumors (NETs). Gastroenteropancreatic (GEP)-NETs are rare, and the distinction between hepatocellular carcinoma (HCC) and metastatic NET can be difficult due to the similarity of their histological characteristics. Herein, we report a case of GEP-NET with hepatic metastasis, which was first misdiagnosed as HCC by liver biopsy and subsequently re-diagnosed after surgery as primary GEP-NET.

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Neuroendocrine metastatic tumors of the liver resembling hepatocellular carcinoma

Cited by 6 publications

References 13 publications

The strengths and weaknesses of gross and histopathological evaluation in hepatocellular carcinoma: a brief review

The strengths and weaknesses of gross and histopathological evaluation in hepatocellular carcinoma: a brief review

Liver Metastases of Neuroendocrine Tumors Rarely Show Overlapping Immunoprofile with Hepatocellular Carcinomas

Gastroenteropancreatic Neuroendocrine Tumor with Hepatic Metastasis Misdiagnosed as Hepatocellular Carcinoma

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