Limits...
Sarcomatoid hepatocellular carcinoma with mixed osteoclast-like giant cells and chondroid differentiation.

Lee KB - Clin Mol Hepatol (2014)

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT

A 64-year-old man was admitted for the resection of a hepatic mass. He had hepatitis B virus-associated chronic liver disease and a several-year history of medical treatments for liver cancer that was first detected 5 years prior. He underwent transarterial embolization (TAE) three times for a 1.4-cm multinodular mass in segment 6 first and percutaneous ethanol injection (PEI) and TAE of a new lesion in segment 6 after 4 years. Seven months after the last treatment, marginal recurrence of a segment 6 mass around the previous PEI defect site was suspected. Magnetic resonance imaging showed a 5-cm lobulating soft tissue mass with an internal hemorrhagic component. Except for the first event showing mild elevation of serum α-fetoprotein (AFP) of 36.1 ng/mL, serum AFP and proteins induced by vitamin K absence (PIVKA) were within the normal range. A peripheral segmentectomy of segment 6 was then performed.

Show MeSH

Related in: MedlinePlus

Macroscopic picture and scan veiw. The mass consisted of (A) a mixture of two different solid components; a white glistening hard lobulating mass and a red friable sponge-like mass extending into the perihepatic adipose tissue. (B) The white mass showed a central hypocellular stroma and peripheral hypercellular tumor nodules. (C) The sponge-like mass showed some cellular components in blood pools [Hematoxylin-eosin stain, original magnification ×12 (B), (C)]
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4197182&req=5

Figure 1: Macroscopic picture and scan veiw. The mass consisted of (A) a mixture of two different solid components; a white glistening hard lobulating mass and a red friable sponge-like mass extending into the perihepatic adipose tissue. (B) The white mass showed a central hypocellular stroma and peripheral hypercellular tumor nodules. (C) The sponge-like mass showed some cellular components in blood pools [Hematoxylin-eosin stain, original magnification ×12 (B), (C)]

Mentions: On gross examination, a 6.0×4.0×2.2 cm solid mass was identified in the cirrhotic hepatic parenchyma. The mass consisted of a mixture of two different solid components abutting each other (Fig. 1A). One was a 2.5×2.0×1.2 cm white glistening hard lobulating mass (Fig. 1B) and the other was a 4.0×4.0×2.0 cm red friable sponge-like mass extending into the perihepatic adipose tissue that resembled a hemangioma or ruptured hepatoma (Fig. 1C). On microscopy, the white lobulating mass was composed of a central hypocellular stroma and peripheral hypercellular tumor nodules (Fig. 1B). Two tumor cell types were seen. The first type was classical hepatocyte-like cells arranged in a microtrabecular pattern with fibrotic stroma or blood-filled sinusoid compatible with classical HCC (Fig. 2A). These cells had hyperchromatic round nuclei, plump eosinophilic cytoplasm, and a distinct cellular membrane, and some mitosis. Edmondson-Steiner's nuclear grade of most of these cells was grade III. The second type was spindle cells showing a storiform pattern. These cells had indistinct cellular membranes, short spindle hyperchromatic nuclei that frequently displayed mitosis (9 per 10 high-powered fields), and some small multinucleated giant cells (Fig. 2B). The hypocellular stroma in the center consisted of a pink hyalinized collagen matrix and a blue chondroid matrix containing viable cells within the lacunae, implying chondroid differentiation (Fig. 2C). The red sponge-like mass showed some cellular components in blood pools (Fig. 1C). The tumor cells were not in an organoid pattern and had ovoid or short spindle-shaped cytoplasm. Hyperchromatic nuclei displayed membrane folding and prominent nuclei, and frequently displayed mitosis (up to 22 per 10 HPF). Large multinucleated giant cells having 10-25 small nuclei within the cytoplasm, the so-called osteoclast-like giant cells (OGC) (Fig. 2D), were occasionally identified in these areas.


Sarcomatoid hepatocellular carcinoma with mixed osteoclast-like giant cells and chondroid differentiation.

Lee KB - Clin Mol Hepatol (2014)

Macroscopic picture and scan veiw. The mass consisted of (A) a mixture of two different solid components; a white glistening hard lobulating mass and a red friable sponge-like mass extending into the perihepatic adipose tissue. (B) The white mass showed a central hypocellular stroma and peripheral hypercellular tumor nodules. (C) The sponge-like mass showed some cellular components in blood pools [Hematoxylin-eosin stain, original magnification ×12 (B), (C)]
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4197182&req=5

Figure 1: Macroscopic picture and scan veiw. The mass consisted of (A) a mixture of two different solid components; a white glistening hard lobulating mass and a red friable sponge-like mass extending into the perihepatic adipose tissue. (B) The white mass showed a central hypocellular stroma and peripheral hypercellular tumor nodules. (C) The sponge-like mass showed some cellular components in blood pools [Hematoxylin-eosin stain, original magnification ×12 (B), (C)]
Mentions: On gross examination, a 6.0×4.0×2.2 cm solid mass was identified in the cirrhotic hepatic parenchyma. The mass consisted of a mixture of two different solid components abutting each other (Fig. 1A). One was a 2.5×2.0×1.2 cm white glistening hard lobulating mass (Fig. 1B) and the other was a 4.0×4.0×2.0 cm red friable sponge-like mass extending into the perihepatic adipose tissue that resembled a hemangioma or ruptured hepatoma (Fig. 1C). On microscopy, the white lobulating mass was composed of a central hypocellular stroma and peripheral hypercellular tumor nodules (Fig. 1B). Two tumor cell types were seen. The first type was classical hepatocyte-like cells arranged in a microtrabecular pattern with fibrotic stroma or blood-filled sinusoid compatible with classical HCC (Fig. 2A). These cells had hyperchromatic round nuclei, plump eosinophilic cytoplasm, and a distinct cellular membrane, and some mitosis. Edmondson-Steiner's nuclear grade of most of these cells was grade III. The second type was spindle cells showing a storiform pattern. These cells had indistinct cellular membranes, short spindle hyperchromatic nuclei that frequently displayed mitosis (9 per 10 high-powered fields), and some small multinucleated giant cells (Fig. 2B). The hypocellular stroma in the center consisted of a pink hyalinized collagen matrix and a blue chondroid matrix containing viable cells within the lacunae, implying chondroid differentiation (Fig. 2C). The red sponge-like mass showed some cellular components in blood pools (Fig. 1C). The tumor cells were not in an organoid pattern and had ovoid or short spindle-shaped cytoplasm. Hyperchromatic nuclei displayed membrane folding and prominent nuclei, and frequently displayed mitosis (up to 22 per 10 HPF). Large multinucleated giant cells having 10-25 small nuclei within the cytoplasm, the so-called osteoclast-like giant cells (OGC) (Fig. 2D), were occasionally identified in these areas.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT

A 64-year-old man was admitted for the resection of a hepatic mass. He had hepatitis B virus-associated chronic liver disease and a several-year history of medical treatments for liver cancer that was first detected 5 years prior. He underwent transarterial embolization (TAE) three times for a 1.4-cm multinodular mass in segment 6 first and percutaneous ethanol injection (PEI) and TAE of a new lesion in segment 6 after 4 years. Seven months after the last treatment, marginal recurrence of a segment 6 mass around the previous PEI defect site was suspected. Magnetic resonance imaging showed a 5-cm lobulating soft tissue mass with an internal hemorrhagic component. Except for the first event showing mild elevation of serum α-fetoprotein (AFP) of 36.1 ng/mL, serum AFP and proteins induced by vitamin K absence (PIVKA) were within the normal range. A peripheral segmentectomy of segment 6 was then performed.

Show MeSH
Related in: MedlinePlus