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首页> 外文期刊>Human Pathology >Atypical hepatocellular adenoma-like neoplasms with β-catenin activation show cytogenetic alterations similar to well-differentiated hepatocellular carcinomas
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Atypical hepatocellular adenoma-like neoplasms with β-catenin activation show cytogenetic alterations similar to well-differentiated hepatocellular carcinomas

机译：具有β-catenin激活的非典型肝细胞腺瘤样肿瘤表现出与高度分化的肝细胞癌相似的细胞遗传学改变

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The distinction of hepatocellular adenoma from well-differentiated hepatocellular carcinoma (HCC) arising in noncirrhotic liver can be challenging, particularly when tumors histologically resembling hepatocellular adenoma occur in unusual clinical settings such as in a man or an older woman or show focal atypical morphologic features. In this study, we examine the morphologic, immunohistochemical, and cytogenetic features of hepatocellular adenoma-like neoplasms occurring in men, women 50 years or older or younger than 15 years, and/or those with focal atypia (small cell change, pseudogland formation, and/or nuclear atypia), designated atypical hepatocellular neoplasms, where the distinction of hepatocellular adenoma versus HCC could not be clearly established. Immunohistochemistry was performed for β-catenin, glutamine synthetase, and serum amyloid A in 31 hepatocellular adenomas, 20 well-differentiated HCCs, and 40 atypical hepatocellular neoplasms. Chromosomal gains/losses had previously been determined in 37 cases using comparative genomic hybridization or fluorescence in situ hybridization. β-Catenin activation was observed in 35% of atypical hepatocellular neoplasms compared with 10% of typical hepatocellular adenomas (P<.05) and 55% of well-differentiated HCCs (P =.14). Cytogenetic changes typically observed in HCC were present in all atypical hepatocellular neoplasms with β-catenin activation. β-Catenin activation in atypical hepatocellular neoplasms was also associated with atypical morphologic features. Follow-up data were limited, but adverse outcome was observed in 2 atypical hepatocellular neoplasms with β-catenin activation (1 recurrence, 1 metastasis); transition to areas of HCC was observed in 1 case. The similarity in morphologic and cytogenetic features of β-catenin-activated hepatocellular adenoma-like tumors and HCC suggests that the former tumors represent an extremely well-differentiated variant of HCC.
机译：肝细胞腺瘤与非肝硬化肝中高分化肝细胞癌（HCC）的区别可能具有挑战性，特别是当组织学上类似于肝细胞腺瘤的肿瘤发生在异常的临床环境中（例如男性或老年女性）或表现出局灶性非典型形态特征时。在这项研究中，我们研究了50岁以上或小于15岁的男性和女性和/或有局灶性非典型性（小细胞改变，假性腺体形成，男性，女性和女性）的肝细胞腺瘤样肿瘤的形态，免疫组化和细胞遗传学特征。和/或核型异型症），称为非典型肝细胞瘤，其中尚不能明确区分肝细胞腺瘤与HCC。对31例肝细胞腺瘤，20例分化良好的HCC和40例非典型肝细胞肿瘤中的β-catenin，谷氨酰胺合成酶和血清淀粉样蛋白A进行了免疫组织化学。先前已经使用比较基因组杂交或荧光原位杂交在37例病例中确定了染色体的得失。在35％的非典型肝细胞瘤中观察到β-连环素的活化，而典型肝细胞腺瘤的10％（P <.05）和高分化肝癌的55％（P = .14）观察到。 HCC中通常观察到的细胞遗传学改变存在于所有具有β-catenin活化的非典型肝细胞肿瘤中。非典型肝细胞肿瘤中β-连环蛋白的活化也与非典型形态特征有关。随访数据有限，但在2例具有β-catenin活化的非典型肝细胞肿瘤中观察到不良结果（1例复发，1例转移）。 1例观察到向肝癌转移。 β-catenin激活的肝细胞腺瘤样肿瘤和HCC在形态学和细胞遗传学特征上的相似性表明，前一种肿瘤代表了HCC的高度分化的变异体。

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