Histopathologic Features of Hepatocellular Carcinoma
|
|
- Joan Jones
- 5 years ago
- Views:
Transcription
1 REVIEW REVIEW Histopathologic Features of Hepatocellular Carcinoma Elizabeth M. Brunt, M.D. Paradoxically, with the recognized increase in hepatocellular carcinoma, liver biopsy is used less frequently for diagnosis unless there are atypical imaging characteristics. 1,2 Thus, unless pathologists practice in a center with high liver surgery volume, experience with this tumor may diminish. However, whether for tissue acquisition for management decisions of the atypical lesions, the incidental lesion encountered in a blind percutaneous biopsy, or for final diagnostic reporting of resected or transplanted hepatectomies, familiarity with the histopathologic lesions of hepatocellular carcinoma remains important for practicing pathologists. As noted in recent reviews, clinical management choices and decisions, and prognosis of primary liver carcinoma are fields of rapid growth. Arguments are now being made that for optimum clinical outcomes, management also necessitates the most reliable classification of tumors, including histopathologic evaluation. 3 5 This review discusses current criteria, useful immunohistochemistry stains, and differential diagnostic considerations for hepatocellular carcinoma. Hepatocellular Carcinoma Hepatocellular carcinoma (HCC), a malignant tumor of hepatocytes, may exhibit any or all of the cytologic and/or architectural characteristics of hepatocellular differentiation, along with features of malignancy. Identification of intercellular bile and/or canaliculi are diagnostic of the cellular origin of the tumor. Figures 1-6 show hematoxylin and eosin (H&E) stained images of routine HCC. Architectural Considerations. The trabecular and pseudoacinar patterns of HCC are the most easily recognized. The former recapitulates hepatic cords, but the width is 3 nuclei; in some cases, floating trabeculae may be appreciated in which there are apparent cross-sections of cords that are not attached or are floating freely. If considered threedimensionally, this could represent a cross-section from a complex growth of tumor with multiple projections. In nontumorous liver, this appearance is seen only in large vein outflow obstruction with sinusoidal dilatation, but the cords are 2 nuclei wide. Pseudoacinar formations may resemble cholestatic rosettes when small; pseudoacini may also be dilated and large, infrequent to numerous, empty or filled with eosinophilic material. More challenging to recognize as HCC is the compact (solid) pattern in which nearly confluent sheets of tumor are present. A characteristic feature of so-called progressed HCC is the presence of unpaired arteries within the tumor nodule. Finally, intravascular or intraductal tumor and stromal invasion are uncommon but diagnostic of malignancy. Stromal invasion is best recognized on large tissue sections of encapsulated HCC in a background of cirrhosis; keratin 7 6 and keratin 19 7 show progressive loss of the perinodular ductular reaction from cirrhotic nodules to dysplastic nodules to HCC. In some cases, apparent overrun of residual portal tracts may also be appreciated in stromal invasion in HCC. Cytologic Considerations. Malignant hepatocytes manifest almost all the features of benign hepatocytes; the exception is accumulation of iron granules. HCC in the setting of iron overload is iron-free. The cytoplasm may be deeply eosinophilic, basophilic, or clear. Cytoplasmic aggregates may include steatosis, fibrinogen (so-called pale bodies), glycogen (clear cells) or glycoprotein inclusions (þ/ periodic acid Schiff with diastase-positive), and Mallory-Denk bodies; intranuclear inclusions include glycogen, cytoplasmic pseudo-inclusions, or large nucleoli. Nuclear contours are often irregular, and the nuclear/cytoplasmic ratio is increased. Giant, multinucleated cells may occur in HCC. An important concept in HCC is that once tumors are no Abbreviations: DN, dysplastic nodule; FLC, fibrolamellar hepatocellular carcinoma; GPC-3, glypican-3; GS, glutamine synthetase; H&E, hematoxylin and eosin; HCC, hepatocellular carcinoma; HSP70, heat shock protein 70; LEL, lympho-epithelial-like carcinoma; pcea, polyclonal carcinoembryonic antigen. From the Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO Potential conflict of interest: Nothing to report. View this article online at wileyonlinelibrary.com VC 2012 by the American Association for the Study of Liver Diseases doi: /cld Clinical Liver Disease, Vol. 1, No. 6, December 2012 An Official Learning Resource of AASLD
2 FIGURE 1. H&E-stained HCC. There are examples of broad trabeculae (white arrows), pseudoglands or pseudoacini (orange arrows), and a bile plug (black arrow). Nuclear contours are irregular and large nucleoli are notable. H&E, magnification 20. FIGURE 3. HCC with large pseudoglands/pseudoacini, deeply eosinophilic cells, and thick fibrous bands coursing through the tumor. This could be confused for fibrolamellar HCC if care is not taken to know the context (cirrhosis, not shown) and features of the cells and stroma. H&E, magnification 20. FIGURE 2. HCC biopsy shows both thin trabeculae and pseudoacini. The lack of normal parenchymal portal tracts or terminal hepatic venules is the initial clue as to the neoplastic nature of this hepatocellular tumor. The pleomorphism and pseudoacini would not be acceptable for adenoma were this in a noncirrhotic liver. H&E, magnification 20. longer well-differentiated, pleomorphism of cytologic phenotype may occur throughout the tumor. Useful Stains. Table 1 lists commonly used stains for routine HCC. It is worth noting that no single stain is entirely sensitive or specific, 8 and the premier stain for diagnosis remains hematoxylin and eosin. Reticulin and immunohistochemistry stains can be used, with care, to confirm (or rarely, exclude) the diagnosis, as discussed below. Immunohistochemistry also plays a large role in the evaluation of FIGURE 4. Well-differentiated HCC (left) is separated from the nontumorous liver (right) by a dense capsule. Without appreciating the dense capsule that lacks ductular reaction, this well-differentiated HCC could be confused for a high-grade dysplastic nodule. There is marked nuclear crowding and a high N/ C ratio; all of this can best be appreciated in comparison to the adjacent nontumorous liver. H&E, magnification 10. phenotypic differentiation of liver carcinoma, as discussed below. Figures 7-10 show stains used commonly for HCC. Histologic Subtypes of Hepatocellular Carcinoma It is increasingly recognized that morphologic subtypes of liver carcinoma exist beyond the obvious broad distinctions of hepatocellular and cholangiocarcinoma. Commonly accepted subtypes are fibrolamellar HCC (FLC), scirrhous HCC, sarcomatoid HCC, and the so-called inflammatory 195 Clinical Liver Disease, Vol. 1, No. 6, December 2012 An Official Learning Resource of AASLD
3 HCC or lympho-epithelial-like carcinoma (LEL). 9 The first, FLC, is characterized by large polygonal tumor cells with prominent nuclei and dark nucleoli along with bands of lamellar fibrosis coursing through it. Tumor cells may contain pale body inclusions. FLC and LEL both are found predominantly in noncirrhotic livers. Scirrhous HCC, on the other hand, may be noted in livers with foci of otherwise typical HCC; the scirrhous component may be subcapsular. Neither the cytology of the tumor cells nor the character of the fibrous component are to be confused with FLC; in addition, it has been noted that treated HCC may become scirrhous in some areas. 9 These tumors are considered separately from FIGURE 5. Peliotic foci are found within the central portion of the well-differentiated HCC shown in Fig. 4. Peliotic formations are not diagnostic of HCC, as they may also occur in hepatocellular adenomas. H&E, magnification 20. FIGURE 6. Reticulin stain in a biopsy of HCC highlights loss of reticulin as well as demonstration of pseudoglands. Gomori s reticulin, magnification 20. TABLE 1: Stains for HCC Stain/IHC Primary Usefulness in HCC Other Useful Findings Comments Reticulin K8 and K18 K7 K20 CD34 pcea CD10 HEPAR1 GPC-3 Highlights loss of normal cord architecture; referred to as loss of reticulin Keratins of hepatocytes; likely not positive in most adenocarcinomas May label cells in up to 50% of cases of HCC Has been found in scattered cells in up to 20% of cases of HCC Labels the endothelial cells of the sinusoids of HCC but not nontumorous liver Labels canaliculi between benign and malignant hepatocytes; will not be as numerous as nontumorous liver Canalicular marker; specific but not as sensitive as pcea Labels mitochondrial enzyme (granular) in mature hepatocytes; thus, may be negative in HCC Useful when positive, not useful when negative; reported to be negative in hepatocellular adenoma Useful when positive, not useful when Very strong and diffuse labeling is highly suggestive of biphenotypic differentiation Is a marker of capillarization, loss of endothelial cell fenestration Cholangiocarcinoma is positive in cytoplasm For clear cell carcinoma, CD10 can be useful to evaluate for cytoplasmic reactivity expected in renal cell carcinoma Best used in comparison with nontumorous liver; easily misinterpreted and does not necessarily distinguish adenoma and HCC Not useful in the K7/K20 algorithm for evaluating carcinomas Caution: may be positive focally and/or diffusely in hepatocellular adenoma Nontumorous liver is strong positive control Nontumorous liver is strong positive control Very limited application in evaluation; may be positive in other cell types Caution: can be patchy ; has been reported in chronic hepatitis C and in DNs GS Zone 3 hepatocytes are normally Characteristic map-like pattern in FNH negative; may be positive in adenoma strongly positive for GS HSP70 Useful in combination with GPC-3 and GS* Caution: may be positive in DNs Annexin-2 Positive in hepatocytes and/or sinusoids Caution: may also be positive in similar patterns in DNs and hepatocellular adenoma Abbreviations: IHC, immunohistochemistry; K, keratin. *See text. 196 Clinical Liver Disease, Vol. 1, No. 6, December 2012 An Official Learning Resource of AASLD
4 FIGURE 7. CD34 immunohistochemistry demonstrates the neovascularization of this HCC. Nontumorous hepatic sinusoids do not react with CD34 antibodies, as the endothelial cells are fenestrated and do not rest on a basement membrane. This pattern of sinusoidal reactivity, however, is not in itself diagnostic of HCC, as it may also occur diffusely or in areas of hepatocellular adenoma. Anti-CD34 immunohistochemistry, magnification 10. FIGURE 9. Polyclonal carcinoembryonic antigen (pcea) immunostaining. pcea cross-reacts with biliary glycoprotein and is reactive in the canaliculi of benign and malignant hepatocytes. Thus, it is a very strong marker of hepatocellular differentiation, as no other cell type has canaliculi. When nontumorous liver is present in a biopsy or resection, it serves as a useful control. It is clear from this example that in HCC the canalicular structures are not uniform. AntipCEA, magnification 40. FIGURE 8. The darkly stained structures in this photomicrograph are keratin 19 (K19)-positive. On the right side, there is a cirrhotic nodule virtually surrounded by K19-positive ductular cells, whereas the tumor on the left of the photomicrograph has no K19 ductular reaction around the edges. For further description, see Ref. 7. Anti-K19 immunohistochemistry, magnification 10. FIGURE 10. GPC-3, an oncofetal protein that is not found in hepatocellular adenoma but may be present in HCC and DNs and has been reported in chronic hepatitis C. The reactivity is as shown: irregular within the tumor and within the cells. The reactivity may be pericanalicular, granular in the cytoplasm, or membranous. Anti-GPC-3, magnification 20. the sclerosing HCC that is associated with hypercalcemia. 9 Sarcomatoid HCC is diagnosed as such when the majority of tumor cells are spindled; this phenotype may also be a result of treatment. With enough sections, identifiable typical HCC is commonly found. 8,9 LEL may or may not be related to Epstein-Barr viral infection as other lympho-epithelial carcinomas are. 9 Varying quantities of mononuclear cells are present within these tumors. Many of the tumors have cholangiolar differentiation. Immunogenic stimuli are not understood. New Topics in Pathology of Hepatocellular Carcinoma Thanks to the careful work of our Japanese colleagues, there is now recognition of two types of HCC that are both <2 cm but have separate long-term outcomes. 10 The first, distinctly nodular, advanced, 10 or progressed HCC, 5 is the classical form of encapsulated HCC with unpaired arteries, usually moderately differentiated but with tumoral cytologic 197 Clinical Liver Disease, Vol. 1, No. 6, December 2012 An Official Learning Resource of AASLD
5 FIGURE 11. Schematic of the currently accepted concepts of progression of clonal populations in chronic liver disease to DNs, early HCC, and progressed HCC. Reprinted with permission from Archives of Pathology & Laboratory Medicine. 12 Copyright College of American Pathologists. FIGURE 12. Differential diagnosis of nonmetastatic nodules in adult liver. Abbreviations: AML, angiomyolipoma; AS, angiosarcoma; CCa, cholangiocarcinoma; EHE, epithelioid hemangioendothelioma; FNH, focal nodular hyperplasia; HCC, hepatocellular carcinoma; HGDN, high-grade dysplastic nodule; IPT, inflammatory pseudotumor; MRN, macroregenerative nodule. heterogeneity, and the long-term prognosis similar to its larger counterparts. CD34 is positive in sinusoids of the tumor. There is a small but documented risk of intrahepatic tumor metastases, and invasion into portal veins. The second form of small HCC is known as early HCC. 10,11 The lesion is vaguely nodular, does not have a capsule, and even though unpaired arteries are present, portal tracts are as well. These tumors receive both arterial and portal blood supply, and CD34 is not uniformly present. Compared with surrounding parenchyma, portal tract numbers are fewer. Microscopically, the tumors are well-differentiated with thin trabeculae, with or without pseudoacini, and blend imperceptibly into adjacent nontumorous parenchyma. Steatosis is common in early HCC; the N/C ratio is increased, lending 198 Clinical Liver Disease, Vol. 1, No. 6, December 2012 An Official Learning Resource of AASLD
6 References 1. Bruix J. Liver cancer: Still a long way to go. Hepatology 2011;54: Bruix J, Sherman M. Management of hepatocellular carcinoma: An update. Hepatology 2011;53: Parisi G. Should a radiological diagnosis of hepatocellular carcinoma be routinely confirmed by a biopsy? Yes. Eur J Intern Med 2012;23: Schirmacher P, Bedossa P, Roskams T, Tiniakos DG, Brunt EM, Zucman-Rossi J, et al. Fighting the bushfire in HCC trials. J Hepatol 2011;55: Roncalli M, Park YN, Di Tommaso L. Histopathological classification of hepatocellular carcinoma. Dig Liver Dis 2010;42(suppl 3):S228-S Park YN, Kojiro M, Di Tommaso L, Dhillon AP, Kondo F, Nakano M, et al. Ductular reaction is helpful in defining early stromal invasion, small hepatocellular carcinomas, and dysplastic nodules. Cancer 2007;109: Lennerz JK, Chapman WC, Brunt EM. Keratin 19 epithelial patterns in cirrhotic stroma parallel hepatocarcinogenesis. Am J Pathol 2011;179: Bedossa P, Paradis V. Hepatocellular carcinoma. In: Saxena R, ed. Practical Hepatic Pathology: A Diagnostic Approach. St. Louis, MO: W.B. Saunders; 2011: Theise ND, Curado MP, Franceschi S, Hytiroglou P, Kudo M, Park YN, et al. Hepatocellular carcinoma. In: Bosman FT, Carneiro F, Hruban RH, Theise ND, eds. WHO Classification of Tumours of the Digestive System. 4th ed. Lyon, France: International Agency for Research on Cancer; 2010: an overall crowded appearance to the involved area. This lesion may be a challenge to distinguish from dysplastic nodules, and there may be East-West discordance in individual cases. 10,11 The definitive demonstration of carcinoma is stromal invasion into the intratumoral portal tracts, but sufficient tumor sampling may not be present in a biopsy sample. Early HCC, as defined, carries a prognosis of slower tumor progression. 9 A schematic of the progression of dysplastic nodules to early and progressed HCC was published and discussed recently. 12 Figure 11 is a reprint of the schematic. With increased application of immunohistochemical panels and molecular studies, several investigators have shown the existence of liver carcinomas that share genetic and phenotypic expression of both hepatocellular and biliary differentiation, regardless of histologic findings. The tumors may be quite homogenous within themselves, or may be heterogenous with areas of clear-cut classical HCC or, less likely, intrahepatic cholangiocarcinoma. Many of the tumors seemingly have nearly blended histologic features in differing fields, while others show an abrupt transition between the two. In many cases, tumor nests, cords, and gland-like structures are present within sclerotic stroma. Terminology continues to be worked out by investigators in this field. The 2010 World Health Organization Classification of Tumors of the Digestive System 9 refers to the entire group as combined hepatocellular-cholangiocarcinoma with subgroups of classical type, and subtypes with stem cell features. Within the latter, there are three further subdivisions: typical, intermediate cell, and cholangiocellular types. Roncalli et al. 5 have proposed three types: (1) HCC with stem/progenitor cell immunophenotype; (2) mixed hepatobiliary carcinoma, classical type; and (3) mixed hepatobiliary carcinoma with stem/progenitor cell phenotype and immunophenotype. These tumors are under intensive investigation, as it is apparent they are neither uncommon nor restricted to cirrhotic (or noncirrhotic) livers. Differential Diagnostic Considerations of HCC The differential diagnostic considerations of nodules in the liver largely depend on the status of the background nontumorous liver. The possibilities for cirrhotic liver differ from those of noncirrhotic liver, as shown in Fig. 12. The potentially most challenging lesions for pathologists to distinguish from HCC in cirrhotic livers are high-grade dysplastic nodules (DN), 10,12 and in noncirrhotic livers, hepatocellular adenomas. 13 Proposals for the first type have been made, including detailed analysis of various routine histologic features such as cord thickness, vascular and capsular invasion and nuclear features, 14 or utilization of immunomarkers with heat shock protein 70 (HSP70), glutamine synthetase (GS), and glypican-3 (GPC-3) in various combinations. 15 One group has suggested the use of annexin Di Tommaso et al. 17 showed that in all DNs in cirrhotic livers studied, positivity for all three (HSP70, GS, and GPC-3) was never seen, but the combination correctly identified 43.7% of HCCs; 72.7% of DN were negative for all three markers. The value of two or three positive markers in liver biopsies has also been published. 11,17 Annexin-2 was most useful in its diffuse sinusoidal pattern (82% of HCCs versus 0 DNs) compared with the hepatocellular or zonal sinusoidal patterns. 16 References are provided for an in-depth review of adenoma and HCC. 13 n CORRESPONDENCE Elizabeth M. Brunt, M.D., Department of Pathology and Immunology, Washington University School of Medicine, 660 S. Euclid Ave., St. Louis, MO ebrunt@path.wustl.edu. 10. Kojiro M, Roskams T. Early hepatocellular carcinoma and dysplastic nodules. Semin Liver Dis 2005;25: Roskams T, Kojiro M. Pathology of early hepatocellular carcinoma: conventional and molecular diagnosis. Semin Liver Dis 2010;30: Park YN. Update on precursor and early lesions of hepatocellular carcinomas. Arch Pathol Lab Med 2011;135: Bioulac-Sage P, Cubel G, Balabaud C, Zucman-Rossi J. Revisiting the pathology of resected benign hepatocellular nodules using new immunohistochemical markers. Semin Liver Dis 2011;31: Quaglia A, Jutand MA, Dhillon A, Godfrey A, Togni R, Bioulac-Sage P, et al. Classification tool for the systematic histological assessment of hepatocellular carcinoma, macroregenerative nodules, and dysplastic nodules in cirrhotic liver. World J Gastroenterol 2005;11: Di Tommaso L, Franchi G, Park YN, Fiamengo B, Destro A, Morenghi E, et al. Diagnostic value of HSP70, glypican 3, and glutamine synthetase in hepatocellular nodules in cirrhosis. Hepatology 2007;45: Longerich T, Haller MT, Mogler C, Aulmann S, Lohmann V, Schirmacher P, et al. Annexin A2 as a differential diagnostic marker of hepatocellular tumors. Pathol Res Pract 2011;207: Di Tommaso L, Destro A, Seok JY, Balladore E, Terracciano L, Sangiovanni A, et al. The application of markers (HSP70 GPC3 and GS) in liver biopsies is useful for detection of hepatocellular carcinoma. J Hepatol 2009;50: Clinical Liver Disease, Vol. 1, No. 6, December 2012 An Official Learning Resource of AASLD
Pathological Classification of Hepatocellular Carcinoma
3 rd APASL Single Topic Conference: HCC in 3D Pathological Classification of Hepatocellular Carcinoma Glenda Lyn Y. Pua, M.D. HCC Primary liver cancer is the 2 nd most common cancer in Asia HCC is the
More informationPATHOLOGY OF LIVER TUMORS
PATHOLOGY OF LIVER TUMORS Pathobasic, 31.05.2016 WHO Classification Approach to a Liver Mass Lesion in a patient with chronic liver disease? Lesion in a patient without chronic liver disease? Malignant
More informationPitfalls in the diagnosis of well-differentiated hepatocellular lesions
2013 Colorado Society of Pathology Pitfalls in the diagnosis of well-differentiated hepatocellular lesions Sanjay Kakar, MD University of California, San Francisco Outline Hepatocellular adenoma: new WHO
More informationAlastair Burt Newcastle University
Alastair Burt Newcastle University Benign Hepatocellular adenoma 8170/0 Focal nodular hyperplasia Malignancy-associated and premalignant lesions Large cell change (formerly dysplasia ) Small cell change
More informationDysplastic Nodules. Department of Pathology, Chonbuk National University Medical School. Woo Sung Moon. Introduction
Dysplastic Nodules Department of Pathology, Chonbuk National University Medical School Woo Sung Moon 만성간질환에발생하는간의결절병변에는재생결절, 형성이상결절및간세포암종이있다. 여러인자에의해손상받은간세포는괴사와재생과정을반복하며재생결절, 형성이상결절을형성하는동안유전자의변이와 epigenetic
More informationFocus on Dysplastic Nodules and Early Hepatocellular Carcinoma: An Eastern Point of View. Masamichi Kojiro
Focus on Dysplastic Nodules and Early Hepatocellular Carcinoma: An Eastern Point of View Masamichi Kojiro Although increasing numbers of equivocal nodular lesions have been detected in patients with liver
More informationLiver Specialty Evening Conference. Matthew M. Yeh, MD, PhD Professor of Pathology Adjunct Professor of Medicine University of Washington, Seattle
Liver Specialty Evening Conference Matthew M. Yeh, MD, PhD Professor of Pathology Adjunct Professor of Medicine University of Washington, Seattle Case History A 65 year-old man presents with abdominal
More informationO Farrell Legacy UPDATE ON WHO NOMENCLATURE. World Health Organization, 2010 DISCLOSURES WITH EMPHASIS ON PROBLEM HEPATOCELLULAR TUMORS
O Farrell Legacy UPDATE ON WHO NOMENCLATURE WITH EMPHASIS ON PROBLEM HEPATOCELLULAR TUMORS Linda Ferrell, MD University of California San Francisco Vice Chair, Director of Surgical Pathology World Health
More informationInvited Re vie W. Analytical histopathological diagnosis of small hepatocellular nodules in chronic liver diseases
Histol Histopathol (1 998) 13: 1077-1 087 http://www.ehu.es/histoi-histopathol Histology and Histopathology Invited Re vie W Analytical histopathological diagnosis of small hepatocellular nodules in chronic
More informationOutline. Hepatocellular Carcinoma Histologic variants. HCC: Histologic variants
2018 Park City AP Update Hepatocellular Carcinoma Histologic variants Sanjay Kakar, MD University of California, San Francisco Outline Histologic variants of HCC Morphologic and Immunohistochemical pitfalls
More informationRaga Ramachandran, MD, PhD Assistant Professor and Director of Medical Education, UCSF Pathology
Variants of Hepatocellular Carcinoma: Practical Issues Raga Ramachandran, MD, PhD Assistant Professor and Director of Medical Education, UCSF Pathology raga.ramachandran@ucsf.edu A full copy of the presentation
More informationMesenchymal Tumors MESENCHYMAL TUMORS OF THE LIVER: WHAT S NEW AND UNUSUAL (MY PERSPECTIVE)
MESENCHYMAL TUMORS OF THE LIVER: WHAT S NEW AND UNUSUAL (MY PERSPECTIVE) CURRENT ISSUES IN ANATOMIC PATHOLOGY MAY 23, 2014 Linda Ferrell, MD, UCSF Mesenchymal Tumors Focus on Vascular Tumors Benign and
More informationMalignant Focal Liver Lesions
Malignant Focal Liver Lesions Other Than HCC Pablo R. Ros, MD, MPH, PhD Departments of Radiology and Pathology University Hospitals Cleveland Medical Center Case Western Reserve University Pablo.Ros@UHhospitals.org
More informationMesenchymal Tumors. Cavernous Hemangioma (CH) VASCULAR TUMORS MESENCHYMAL TUMORS OF THE LIVER: WHAT S NEW AND UNUSUAL (MY PERSPECTIVE)
Mesenchymal Tumors MESENCHYMAL TUMORS OF THE LIVER: WHAT S NEW AND UNUSUAL (MY PERSPECTIVE) CURRENT ISSUES IN ANATOMIC PATHOLOGY MAY 23, 2014 Linda Ferrell, MD, UCSF Focus on Vascular Tumors Benign and
More informationDifferential diagnosis of HCC
Hepatocellular Carcinoma Quest for an Ideal Immunohistochemical Panel Sanjay Kakar, MD UCSF Differential diagnosis of HCC Hepatocellular lesions Adenoma, FNH, HG dysplasia Adenocarcinoma CholangioCA, metastasis
More informationAtypical Well differentiated Hepatocellular Neoplasms Cruising through the maze of criteria, terminology and risk assessment
2016 Hans Popper Companion Meeting Atypical Well differentiated Hepatocellular Neoplasms Cruising through the maze of criteria, terminology and risk assessment Disclosure Dr. Kakar has nothing to Disclose
More informationPathogenesis of Cholangiolocellular Carcinoma: Possibility of an Interlobular Duct Origin
REVIEW ARTICLE Pathogenesis of Cholangiolocellular Carcinoma: Possibility of an Interlobular Duct Origin Fukuo Kondo 1,2 and Toshio Fukusato 2 Abstract Cholangiolocellular carcinoma (CoCC) is categorized
More informationHepatocelluar nodules in liver cirrhosis: hemodynamic evaluation (angiographyassisted CT) with special reference to multi-step hepatocarcinogenesis
Abdominal Imaging ª The Author(s) 2011. This article is published with open access at Springerlink.com Published online: 26 January 2011 Abdom Imaging (2011) 36:264 272 DOI: 10.1007/s00261-011-9685-1 INVITED
More informationGross appearance of nodular hyperplasia in material obtained from suprapubic prostatectomy. Note the multinodular appearance and the admixture of
Tiền liệt tuyến Tiền liệt tuyến Gross appearance of nodular hyperplasia in material obtained from suprapubic prostatectomy. Note the multinodular appearance and the admixture of solid and microcystic areas.
More informationPapillary Lesions of the breast
Papillary Lesions of the breast Emad Rakha Professor of Breast Pathology The University of Nottingham Papillary lesions of the breast are a heterogeneous group of disease, which are characterised by neoplastic
More informationXIII. Tumours of the liver and biliary system
XIII. Tumours of the liver and biliary system V. PONOMARKOV 1 & L. J. MACKEY 2 In this histological classification of liver and gall bladder tumours the tumour types largely correspond to those found in
More informationBasic patterns of liver damage what information can a liver biopsy provide and what clinical information does the pathologist need?
Basic patterns of liver damage what information can a liver biopsy provide and what clinical information does the pathologist need? Rob Goldin r.goldin@imperial.ac.uk Fatty liver disease Is there fatty
More informationDetection and Characterization of Hepatocellular Carcinoma by Imaging
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 2005;3:S136 S140 Detection and Characterization of Hepatocellular Carcinoma by Imaging OSAMU MATSUI Department of Imaging Diagnosis and Interventional Radiology,
More informationEvaluation of Liver Mass Lesions. American College of Gastroenterology 2013 Regional Postgraduate Course
Evaluation of Liver Mass Lesions American College of Gastroenterology 2013 Regional Postgraduate Course Lewis R. Roberts, MB ChB, PhD Division of Gastroenterology and Hepatology Mayo Clinic College of
More informationDisclosures. Parathyroid Pathology. Objectives. The normal parathyroid 11/10/2012
Disclosures Parathyroid Pathology I have nothing to disclose Annemieke van Zante MD/PhD Assistant Professor of Clinical Pathology Associate Chief of Cytopathology Objectives 1. Review the pathologic features
More informationnumber Done by Corrected by Doctor Maha Shomaf
number 16 Done by Waseem Abo-Obeida Corrected by Zeina Assaf Doctor Maha Shomaf MALIGNANT NEOPLASMS The four fundamental features by which benign and malignant tumors can be distinguished are: 1- differentiation
More informationIntrahepatic Sarcomatoid Cholangiocarcinoma with Portal Vein Thrombosis: A Case Report 1
Intrahepatic Sarcomatoid Cholangiocarcinoma with Portal Vein Thrombosis: A Case Report 1 Jae-Hoon Lim, M.D., Jin Woong Kim, M.D., Suk Hee Heo, M.D., Yong Yeon Jeong, M.D., Heoung Keun Kang, M.D. A 53-year-old
More informationReview Article Assessment of Stromal Invasion for Correct Histological Diagnosis of Early Hepatocellular Carcinoma
SAGE-Hindawi Access to Research International Hepatology Volume 2011, Article ID 241652, 7 pages doi:10.4061/2011/241652 Review Article Assessment of Stromal Invasion for Correct Histological Diagnosis
More informationG3.02 The malignant potential of the neoplasm should be recorded. CG3.02a
G3.02 The malignant potential of the neoplasm should be recorded. CG3.02a Conventional adrenocortical neoplasm. Each of the below parameters is scored 0 when absent and 1 when present. 3 or more of these
More informationVideo Microscopy Tutorial 8
Video Microscopy Tutorial 8 Common and Uncommon Lesions of the Liver Gladwyn Leiman, MD There are no disclosures necessary. Common and Uncommon Lesions in Liver FNA Gladwyn Leiman University of Vermont
More informationAutoimmune Hepatitis: Histopathology
REVIEW Autoimmune Hepatitis: Histopathology Stephen A. Geller M.D.*, Autoimmune hepatitis (AIH), a chronic hepatic necroinflammatory disorder, occurs mostly in women. AIH is characterized by prominent
More information8 years later! Next Generation Sequencing. Pathogenic Findings: HNF1A c.864delinscc, p.g292rfs*25 (NM_ ) (VAF: 59%) HNF1A Loss
8 years later! Next Generation Sequencing Pathogenic Findings: HNF1A c.864delinscc, p.g292rfs*25 (NM_000545.6) (VAF: 59%) HNF1A Loss Interpretation HNF1A c.864delinscc, p.g292rfs*25 (NM_000545.6) This
More informationHEPATOCYTE SPECIFIC CONTRAST MEDIA: WHERE DO WE STAND?
HEPATOCYTE SPECIFIC CONTRAST MEDIA: WHERE DO WE STAND? Andrew T. Trout, MD @AndrewTroutMD Disclosures No relevant disclosures Outline Review of hepatocyte specific contrast media Review of hepatocellular
More informationPapillary Lesions of the Breast A Practical Approach to Diagnosis. (Arch Pathol Lab Med. 2016;140: ; doi: /arpa.
Papillary Lesions of the Breast A Practical Approach to Diagnosis (Arch Pathol Lab Med. 2016;140:1052 1059; doi: 10.5858/arpa.2016-0219-RA) Papillary lesions of the breast Span the spectrum of benign,
More informationPathological Analysis of Small Hepatocellular Carcinoma with Poor Prognosis
Pathological Analysis of Small Hepatocellular Carcinoma with Poor Prognosis Haeryoung Kim, M.D., Ph.D. Department of Pathology Seoul National University Bundang Hospital Small HCC Definition: HCC < 2cm
More informationHepatocellular carcinoma Cholangiocarcinoma. Jewels of hepatobiliary cancer imaging : what to look for? Imaging characteristics of HCC.
Outline : Imaging Jewels Jewels of hepatobiliary cancer imaging : what to look for? Hepatocellular carcinoma Cholangiocarcinoma Surachate Siripongsakun, M.D. Chulabhorn Cancer Center Imaging characteristics
More informationLiver Tumors. Prof. Dr. Ahmed El - Samongy
Liver Tumors Prof. Dr. Ahmed El - Samongy Objective 1. Identify the most important features of common benign liver tumors 2. Know the risk factors, diagnosis, and management of hepatocellular carcinoma
More informationHistopathology: Cervical HPV and neoplasia
Histopathology: Cervical HPV and neoplasia These presentations are to help you identify basic histopathological features. They do not contain the additional factual information that you need to learn about
More informationProliferative Epithelial lesions of the Breast. Sami Shousha, MD, FRCPath Charing Cross Hospital & Imperial College, London
Proliferative Epithelial lesions of the Breast Sami Shousha, MD, FRCPath Charing Cross Hospital & Imperial College, London Amman, November2013 Proliferative Epithelial Lesions of the Breast Usual type
More information2014 CURRENT ISSUES IN PATHOLOGY
2014 CURRENT ISSUES IN PATHOLOGY SPECIAL STAINS IN LIVER BIOPSY PATHOLOGY Sanjay Kakar, MD University of California, San Francisco Trichrome stain : (1) Assess degree of fibrosis. H&E stain is not reliable
More informationNormal thyroid tissue
Thyroid Pathology Overview Normal thyroid tissue Normal thyroid tissue with follicles filled with colloid. Thyroid cells form follicles, spheres of epithelial cells (always single layered in health, usually
More informationNeoplasms of the Canine, Feline and Lemur Liver:
Neoplasms of the Canine, Feline and Lemur Liver: Classification and Prognosis Annual Seminar of the French Society of Veterinary Pathology John M. Cullen VMD PhD DACVP North Carolina State University Primary
More informationCT & MRI of Benign Liver Neoplasms Srinivasa R Prasad
CT & MRI of Benign Liver Neoplasms Srinivasa R Prasad No financial disclosures Acknowledgements Many thanks to Drs. Heiken, Narra & Menias (MIR) Dr. Sahani (MGH) for sharing images Benign Liver Tumors:
More informationLiver Pathology in the 0bese
Liver Pathology in the 0bese Rob Goldin Centre for Pathology, Imperial College r.goldin@imperial.ac.uk Ludwig et al. Non-alcoholic steatohepatitis: Mayo Clinic experiences with a hitherto unnamed disease.
More informationACRIN 6690 PATHOLOGY MANUAL
ACRIN 6690 PATHOLOGY MANUAL ACRIN 6690 Prepared by the American College of Radiology Imaging Network Original: December 15, 2010 Version Date: May 3, 2012 American College of Radiology Imaging Network
More informationInteresting Cases from Liver Tumor Board. Jeffrey C. Weinreb, M.D.,FACR Yale University School of Medicine
Interesting Cases from Liver Tumor Board Jeffrey C. Weinreb, M.D.,FACR Yale University School of Medicine jeffrey.weinreb@yale.edu Common Liver Diseases Hemangioma Cyst FNH Focal Fat/Sparing THID Non-Cirrhotic
More informationactivated hepatocellular adenoma
pissn 2287-2728 eissn 2287-285X Liver Pathology Clinical and Molecular Hepatology 2013;19:185-189 5.2 3.6 cm sized, homogeneous, green colored hepatic mass was observed on the cut section (Fig. 1). The
More informationARTHUR PURDY STOUT SOCIETY COMPANION MEETING: DIFFICULT NEW DIFFERENTIAL DIAGNOSES IN PROSTATE PATHOLOGY. Jonathan I. Epstein.
1 ARTHUR PURDY STOUT SOCIETY COMPANION MEETING: DIFFICULT NEW DIFFERENTIAL DIAGNOSES IN PROSTATE PATHOLOGY Jonathan I. Epstein Professor Pathology, Urology, Oncology The Reinhard Professor of Urological
More informationNEOPLASMS AND TUMOR-LIKE CONDITIONS OF LIVER
NEOPLASMS AND TUMOR-LIKE CONDITIONS OF LIVER Epithelial Tumors Focal nodular hyperplasia Focal nodular hyperplasia is a localized hyperplasic overgrowth of hepatocytes around a vascular anomaly, particularly
More informationHEPATO-BILIARY IMAGING
HEPATO-BILIARY IMAGING BY MAMDOUH MAHFOUZ MD PROF.OF RADIOLOGY CAIRO UNIVERSITY mamdouh.m5@gmail.com www.ssregypt.com CT ABDOMEN Indications Patient preparation Patient position Scanogram Fasting 4-6 hours
More informationLIVER IMAGING TIPS IN VARIOUS MODALITIES. M.Vlychou, MD, PhD Assoc. Professor of Radiology University of Thessaly
LIVER IMAGING TIPS IN VARIOUS MODALITIES M.Vlychou, MD, PhD Assoc. Professor of Radiology University of Thessaly Hepatocellular carcinoma is a common malignancy for which prevention, screening, diagnosis,
More informationin liver pathology? 2014 What s hot
Medizinische Fakultät Institut für Pathologie BSG Annual Liver Pathology Update Meeting Stratford upon Avon 20 November 2014 2014 What s hot in liver pathology? Dina G. Tiniakos Dept of Cellular Pathology,
More informationIntrahepatic cholangiocarcinoma Histologic spectrum, novel markers and molecular assays
2018 Current Issues in Surgical Pathology Summary (not actual lecture) Intrahepatic cholangiocarcinoma Histologic spectrum, novel markers and molecular assays Sanjay Kakar, MD University of California,
More informationMultistep hepatocarcinogenesis is characterized by the following
Early hepatocellular carcinoma with high-grade atypia in small vaguely nodular lesions Hidenori Ojima, 1 Yohei Masugi, 1 Hanako Tsujikawa, 1 Katsura Emoto, 1 Yoko Fujii-Nishimura, 1 Mami Hatano, 1 Miho
More informationPitfalls in thyroid tumor pathology. Prof.Valdi Pešutić-Pisac MD, PhD
Pitfalls in thyroid tumor pathology Prof.Valdi Pešutić-Pisac MD, PhD Too many or... Tumour herniation through a torn capsule simulating capsular invasion fibrous capsule with a sharp discontinuity, suggestive
More informationSlide 7 demonstrates acute pericholangitisis with neutrophils around proliferating bile ducts.
Many of the histologic images and the tables are from MacSween s Pathology of the Liver (5 th Edition). Other images were used from an online source called PathPedia.com. A few images from other sources
More informationDisorders of Cell Growth & Neoplasia. Histopathology Lab
Disorders of Cell Growth & Neoplasia Histopathology Lab Paul Hanna April 2010 Case #84 Clinical History: 5 yr-old, West Highland White terrier. skin mass from axillary region. has been present for the
More informationBasic patterns of liver damage what information can a liver biopsy provide and what clinical information does the pathologist need?
Basic patterns of liver damage what information can a liver biopsy provide and what clinical information does the pathologist need? Rob Goldin r.goldin@imperial.ac.uk @robdgol FATTY LIVER DISEASE Brunt
More informationPITFALLS IN THE DIAGNOSIS OF MEDICAL LIVER DISEASE WITH TWO CONCURRENT ETIOLOGIES I HAVE NOTHING TO DISCLOSE CURRENT ISSUES IN ANATOMIC PATHOLOGY 2017
CURRENT ISSUES IN ANATOMIC PATHOLOGY 2017 I HAVE NOTHING TO DISCLOSE Linda Ferrell PITFALLS IN THE DIAGNOSIS OF MEDICAL LIVER DISEASE WITH TWO CONCURRENT ETIOLOGIES Linda Ferrell, MD, UCSF THE PROBLEM
More informationMody. AIS vs. Invasive Adenocarcinoma of the Cervix
Common Problems in Gynecologic Pathology Michael T. Deavers, M.D. Houston Methodist Hospital, Houston, Texas Common Problems in Gynecologic Pathology Adenocarcinoma in-situ (AIS) of the Cervix vs. Invasive
More informationBritish Liver Transplant Group Pathology meeting September Leeds cases
British Liver Transplant Group Pathology meeting September 2014 Leeds cases Leeds Case 1 Male 61 years Liver transplant for HCV cirrhosis with HCC in January 2014. Now raised ALT and bilirubin,? acute
More informationMalignant neoplasms of the gastrointestinal (GI) tract,
Special Section First Chinese American Pathologists Association Diagnostic Pathology Course, Part II Practical Immunohistochemistry in Neoplastic Pathology of the Gastrointestinal Tract, Liver, Biliary
More informationHepatocellular neoplasia - Recent developments
22 November 2018 Hepatocellular neoplasia - Recent developments Dina G. Tiniakos Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle University, UK Dept of Pathology, Aretaieion Hospital,
More informationInteresting case. Vikas Kundra, M.D., Ph.D. October Vikas Kundra, M.D., Ph.D.
Interesting case October 2012 Disclosure Information Vikas Kundra, M.D, Ph.D. I have no financial relationships to disclose. I WILL NOT include discussion of investigational or off-label use of a product
More informationACCME/Disclosures. Cribriform Lesions of the Prostate. Case
Cribriform Lesions of the Prostate Ming Zhou, MD, PhD Departments of Pathology and Urology New York University Langone Medical Center New York, NY Ming.Zhou@NYUMC.ORG ACCME/Disclosures The USCAP requires
More informationCase Report Sarcomatoid combined hepatocellular-cholangiocarcinoma: a case report and review of literature
Int J Clin Exp Pathol 2014;7(11):8290-8294 www.ijcep.com /ISSN:1936-2625/IJCEP0002430 Case Report Sarcomatoid combined hepatocellular-cholangiocarcinoma: a case report and review of literature Susie Chin
More informationPrimary Liver Carcinoma Arising in People Younger Than 30 Years
Anatomic Pathology / PRIMARY LIVER CARCINOMA Primary Liver Carcinoma Arising in People Younger Than 30 Years Walter M. Klein, MD, 1 Ernesto P. Molmenti, MD, 2 Paul M. Colombani, MD, 2 Davinder S. Grover,
More informationKidney Case 1 SURGICAL PATHOLOGY REPORT
Kidney Case 1 Surgical Pathology Report February 9, 2007 Clinical History: This 45 year old woman was found to have a left renal mass. CT urography with reconstruction revealed a 2 cm medial mass which
More informationSynonyms. Nephrogenic metaplasia Mesonephric adenoma
Nephrogenic Adenoma Synonyms Nephrogenic metaplasia Mesonephric adenoma Definition Benign epithelial lesion of urinary tract with tubular, glandular, papillary growth pattern Most frequently in the urinary
More informationWith the widespread use of hepatic imaging, liver masses
2B: Liver Assessment of the Liver Mass: What Do You Need to Know? With the widespread use of hepatic imaging, liver masses are detected either unexpectedly or in the course of screening for liver cancer
More informationEvangelos Chartampilas Bioclinic Hospital Thessaloniki, Greece
Evangelos Chartampilas Bioclinic Hospital Thessaloniki, Greece Hepatospecificcontrast agents Gadobenate dimeglumine (Multihance) Gadoxeticacid (Primovist) 3-5% liver uptake 50% liver uptake Hepatobiliary
More informationEssentials of Clinical MR, 2 nd edition. 65. Benign Hepatic Masses
65. Benign Hepatic Masses Pulse sequences acquired for abdominal MRI typically consist of fast acquisition schemes such as single-shot turbo spin echo (i.e. HASTE) and gradient echo schemes such as FLASH
More informationLiver Tumors Selected Topics Romil Saxena, MD
Liver Tumors Selected Topics Romil Saxena, MD Hepatocellular carcinoma 90% of all liver tumors Large cells with abundant eosinophilic cytoplasm that grow in a trabecular pattern 1 Case 1 55 male PET -
More informationJesse Civan, M.D. Medical Director, Jefferson Liver Tumor Center
Liver Tumors Jesse Civan, M.D. Medical Director, Jefferson Liver Tumor Center Differential Diagnosis Malignant Metastatic from non-hepatic primary Hepatocellular carcinoma Cholangiocarcinoma Biliary cystcarcinoma
More informationTinh hoàn
Tinh hoàn Tinh hoàn Tinh hoàn Tiền liệt tuyến Tiền liệt tuyến Mào tinh hoàn Mào tinh hoàn Túi tinh Túi tinh Túi tinh Túi tinh So-called cystadenoma of seminal vesicle. Gross appearance of granulomatous
More informationAtypical Hyperplasia/EIN
EIN Atypical Hyperplasia/EIN Based on scientific and diagnostic advances, in 2014 the WHO moved that the precursor lesion for endometrioid carcinoma be atypical hyperplasia/ein, rather than what was previously
More informationA 53 year-old woman with a lung mass, right hilar mass and mediastinal adenopathy.
November 2015 Case of the Month A 53 year-old woman with a lung mass, right hilar mass and mediastinal adenopathy. Contributed by: Rasha Salama, M.D., IU Department of Pathology and Laboratory Medicine
More informationFollicular Derived Thyroid Tumors
Follicular Derived Thyroid Tumors Jennifer L. Hunt, MD, MEd Aubrey J. Hough Jr, MD, Endowed Professor of Pathology Chair of Pathology and Laboratory Medicine University of Arkansas for Medical Sciences
More informationLUNG CANCER PATHOLOGY: UPDATE ON NEUROENDOCRINE LUNG TUMORS
LUNG CANCER PATHOLOGY: UPDATE ON NEUROENDOCRINE LUNG TUMORS William D. Travis, M.D. Attending Thoracic Pathologist Memorial Sloan Kettering Cancer Center New York, NY PULMONARY NE TUMORS CLASSIFICATION
More informationHepatocellular adenomas (HCAs) are uncommon primary benign tumours. They are constantly monoclonal tumours.
Hepatocellular adenoma: Evaluation with contrast enhanced ultrasound, MRI And Correlation with pathologic and phenotypic classification. About 26 lesions. Poster No.: C-1561 Congress: ECR 2011 Type: Scientific
More informationDILI PATHOLOGY. PHILIP KAYE November 2017 BSG Pathology Winter Meeting
DILI PATHOLOGY PHILIP KAYE November 2017 BSG Pathology Winter Meeting General Mechanisms Role of Liver Biopsy Outline Kleiner Categories Pathology! Differentials Severity Finally Drugs/Toxins may cause
More informationGross appearance of peritoneal cysts. They have a thin, translucent wall and contain a clear fluid.
Gross appearance of peritoneal cysts. They have a thin, translucent wall and contain a clear fluid. So-called multicystic benign mesothelioma. A, Gross appearance. So-called multicystic benign mesothelioma.
More informationNew insights into fatty liver disease. Rob Goldin Centre for Pathology, Imperial College
New insights into fatty liver disease Rob Goldin Centre for Pathology, Imperial College r.goldin@imperial.ac.uk Prevalence of NASH Global prevalence of NAFLD is 25% with highest prevalence in the Middle
More informationencapsulated thyroid nodule with a follicular architecture and some form of atypia. The problem is when to diagnose
Histological Spectrum of Papillary Carcinoma of Thyroid A Two Years Study Gomathi Srinivasan 1, M. Vennila 2 1 Associate Professor Pathology, Government Medical College, Omandurar Estate, Chennai 600 002
More informationPrimary and Metastatic Tumours of the Liver: Expanding Scope of Morphological and Immunohistochemical Details in the Biopsy
Chapter 7 Primary and Metastatic Tumours of the Liver: Expanding Scope of Morphological and Immunohistochemical Details in the Biopsy Ilze Strumfa, Janis Vilmanis, Andrejs Vanags, Ervins Vasko, Dzeina
More informationPLEOMORPHIC ADENOMA ( BENIGN MIXED TUMOR )
( BENIGN MIXED TUMOR ) Grossly, the tumor is freely movable, solid, sometimes lobulated and occasionally cystic. If recurrent, multinodular masses are common. Histologically, within a fibrous capsule,
More informationAn Alphabet Soup of Thyroid Neoplasms
Overall Objectives An Alphabet Soup of Thyroid Neoplasms Lester D. R. Thompson www.lester-thompson.com What is the current management of papillary carcinoma? What are the trends and what can we do differently?
More informationPrepared By Jocelyn Palao and Layla Faqih
Prepared By Jocelyn Palao and Layla Faqih The structure of the suspected atypical cell should always be compared to the structure of other similar, benign, cells which are present in the smears. The diagnosis
More informationPart 3. Case #7 History:
Part 3 Case #7 History: The patient is a 25 year old woman who had a colectomy for familial adenomatous polyposis 2 years ago. No carcinoma was found in her colectomy specimen. She presents now with 2
More informationTHYMIC CARCINOMAS AN UPDATE
THYMIC CARCINOMAS AN UPDATE Mark R. Wick, M.D. University of Virginia Medical Center Charlottesville, VA CARCINOMA OF THE THYMUS General Clinical Features No apparent gender predilection Age range of 35-75
More informationUpdate on 2015 WHO Classification of Lung Adenocarcinoma 1/3/ Mayo Foundation for Medical Education and Research. All rights reserved.
1 Our speaker for this program is Dr. Anja Roden, an associate professor of Laboratory Medicine and Pathology at Mayo Clinic as well as consultant in the Anatomic Pathology Laboratory and co-director of
More informationNatural History and Treatment Trends in Hepatocellular Carcinoma Subtypes: Insights From a National Cancer Registry
2015;112:872 876 Natural History and Treatment Trends in Hepatocellular Carcinoma Subtypes: Insights From a National Cancer Registry PETER L. JERNIGAN, MD, KOFFI WIMA, MS, DENNIS J. HANSEMAN, PhD, RICHARD
More informationAmong the benign intraepithelial melanocytic proliferations, Inflamed Conjunctival Nevi. Histopathological Criteria. Resident Short Reviews
Resident Short Reviews Inflamed conjunctival nevi (ICN) may suggest malignancy because of their rapid growth and atypical histology. The objective of this study was to characterize the diagnostic features
More informationMammary Nodular Hyperplasia in Intact R hesus Monkeys
Vet. Path. 10: 130-134 (1973) Mammary Nodular Hyperplasia in Intact R hesus Monkeys L. W NELSON and L. D. SHOTT Department of Pathology and Toxicology, Mead Johnson Research Center, Evansville, Ind., and
More informationAileen Wee. 1. Introduction
SAGE-Hindawi Access to Research Pathology Research International Volume 2011, Article ID 587936, 17 pages doi:10.4061/2011/587936 Review Article Fine-Needle Aspiration Biopsy of Hepatocellular Carcinoma
More informationHepatocellular adenomas are benign liver tumors,
Case Report Hepatobiliary & Pancreatic Diseases International Pigmented well-differentiated hepatocellular neoplasm with β-catenin mutation Lara Neves Souza, Rodrigo Bronze de Martino, Richard Thompson,
More informationSpecial stains in liver pathology
Current Issues in Surgical Pathology 2014 Special stains in liver pathology Which, why, how Really? Sanjay Kakar, MD University of California, San Francisco Outline Which stains Why the stain is done How
More informationEnhancements in Hepatobiliary Imaging:
Enhancements in Hepatobiliary Imaging: S. Channual 1, MD; A. Pahwa 2, MD; S. Raman 1, MD. 1 UCLA Medical Center, Department of Radiologic Sciences 2 Olive-View UCLA Medical Center, Department of Radiology
More informationDiseases of the breast (1 of 2)
Diseases of the breast (1 of 2) Introduction A histology introduction Normal ducts and lobules of the breast are lined by two layers of cells a layer of luminal cells overlying a second layer of myoepithelial
More information