Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019204 (hepatocellular carcinoma)
 71,386 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 47-year-old man who had been treated with an anabolic steroid for refractory anemia developed an intrahepatic cholangiocarcinoma with metastases to abdominal lymph nodes and lungs. Microscopically, the tumor showed mucin production and was devoid of hepatocellular elements. Previous reports have suggested a possible relationship between anabolic steroid therapy and hepatocellular carcinoma. In many such cases, there are doubts about the histological diagnosis, malignant potential, and the nature of the association between the steroids and the tumors. The presence of distant metastases attests to the malignant nature of the tumor in the present case. Despite the apparent temporal eligibility of the steroid as an etiologic agent, a causative relationship between therapy and tumor is not established.
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PMID:Anabolic steroid therapy and intrahepatic cholangiocarcinoma. 21 19

To improve the qualitative diagnosis of ultrasonography (US) of minute malignant hepatic nodules, we studied the accurate and direct correlations between US and histopathology of 33 lesions using formalin-fixed autopsied livers. The target nodules were cut on the same plane as their US-image. The solid nests of malignant tumor without degeneration were hypoechoic on US. Hepatocellular carcinoma showed a wide variety of echo levels, from hypoechoic to isoechoic, and its images were more heterogeneous than those of other malignant lesions. The squamous cell carcinoma ranged from hypoechoic to hyperechoic according to the degree of keratinization. US may be useful for evaluating the degree of differentiation in squamous cell carcinoma. Marked mucin-production and "comedo" pattern seem to be histological factors of the hyperechoic US image of adenocarcinoma. This study may contribute to improve the quality of US-diagnosis of minute hepatic nodular lesions.
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PMID:Direct correlation between sonography and histology of minute malignant hepatic nodule. 132 Jul 59

Vascular invasion is not a prominent feature of cholangiocarcinoma (CCC), in contrast to hepatocellular carcinoma (HCC), which frequently shows extensive vascular tumor thrombi. We report an autopsy case of CCC with extensive portal tumor thrombi and portal hypertension. A 57-yr-old man presented with abdominal pain. Liver imaging revealed no tumors, but showed intrahepatic portal venous obstruction. HCC with portal tumor thrombi was suspected clinically. His clinical course was rapid; he died of hepatic failure 50 days after admission. At autopsy, the liver (2,700 g) was studded with diffuse whitish yellow granular areas with flecks of coalescent granules. Intrahepatic portal veins were diffusely occluded by tumor thrombi. Microscopically, the tumor was poorly differentiated adenocarcinoma with mucin; tumor cells were immunohistochemically positive for carcinoembryonic antigen, CA 19-9, DU-PAN-2, and biliary type cytokeratins, but negative for alpha-fetoprotein. Tumor cells were diffuse in the liver, and there were numerous tumor thrombi in the small portal veins. Hepatic veins and small arteries were occasionally occluded by tumor thrombi. There was ascites, splenomegaly and tumor thrombi in the gastric and esophageal veins, suggesting that portal hypertension had been present. This tumor seemed to have marked affinity to invade portal veins. It must be stressed that there are CCCs with extensive portal tumor thrombi and resultant portal hypertension.
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PMID:Extensive portal tumor thrombi with portal hypertension in an autopsy case of intrahepatic cholangiocarcinoma. 132 98

Metastasis of hepatoma to the brain is a rare event. Even rarer is massive hemorrhage of the brain associated with metastatic hepatoma. A 57-year-old man had cirrhosis of the liver with hepatocellular carcinoma. The tumor spread to the lungs and left occipital lobe of the brain. The primary and secondary neoplasms were negative in detection of mucin, but were immunohistochemically positive to cytokeratin CAM 5.2 and KC; the finding supported the hepatocellular origin of the tumor. The metastatic tumor formed papillae in the lung and produced massive hemorrhage in the left occipital lobe. This case raised the total number of intracranial metastatic hepatic carcinomas to 34 cases. Five of 34 hepatic carcinomas metastatic to brain, including the current one, were hepatocellular carcinoma that produced massive hemorrhage.
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PMID:Massive cerebral hemorrhage from metastatic hepatocellular carcinoma. 166 19

To clarify the morphology and pathogenesis of intrahepatic calculi in the incipient stage, we examined biliary sludge and microcalculi in intrahepatic bile ducts by morphologic and X-ray microanalytical methods in 18 (1.5%) among 1,179 autopsied livers. The hepatobiliary conditions of these 18 livers were intra- and extrahepatic biliary obstruction in 14 cases, hepatic fibrosis in three cases, and cirrhosis with hepatocellular carcinoma in the remaining one. Grossly, brown-pigmented microcalculi were observed floating in biliary sludge. Microscopically, the biliary sludge was composed of mucin, fibrinous materials, desquamated epithelial cells and a few bilirubin granules. The microcalculi were embedded in the sludge and consisted of mucin and precipitates of bilirubin with a granular, lamellar or amorphous appearance. Bacterial colonies were recognized in both the sludge and microcalculi in all but three cases. Intrahepatic bile ducts harboring sludge and microcalculi showed a minimal to moderate degree of glandular proliferation with mucin production. X-ray microanalysis disclosed that the sludge contained little calcium ion, whereas microcalculi were calcium-rich. These findings suggest that biliary obstruction, bacterial infection and mucin hypersecretion play an important role in the formation of intrahepatic biliary sludge and microcalculi, and that sludge is causally related to the formation of intrahepatic microcalculi. Intrahepatic microcalculi and biliary sludge may represent a pathogenetic sequence in the early stage of calcium bilirubinate hepatolithiasis.
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PMID:Biliary sludge and microcalculi in intrahepatic bile ducts. Morphologic and X-ray microanalytical observations in 18 among 1,179 consecutively autopsied livers. 209 92

A combined hepatocellular and cholangiocellular carcinoma of diffuse type in a Japanese man is described. A small localized solitary tumor apparently grew rapidly into a diffuse-type carcinoma, and the liver weight increased about 4-fold during the last two months. The clinical course of this case was as expected for a diffuse type of hepatocellular carcinoma except that unusually high levels of serum carcinoembryonic antigen were found. The patient died of hepatic failure with systemic bleeding five months later. At autopsy, multiple small nodules were suspected to be intrahepatic metastatic foci because portal tumor thrombus was observed in the right antero-superior segment where the initial tumor was localized. Histologically, the tumor had components of both hepatocellular and mucin-producing cholangiocellular carcinoma. This is believed to be the first report on a diffuse type of combined hepatocellular and cholangiocellular carcinoma initially presented as a localized small nodule.
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PMID:A case of diffuse type of combined hepatocellular and cholangiocellular carcinoma initially presented as a localized small nodule. 241 97

A histopathologic study of pseudoglandular formation was made by observing selected 39 cases of hepatocellular carcinoma (HCC). The pseudoglands were most often derived from the dilatation of bile canaliculi (28/39). The dilated canaliculi were sometimes connected and divided a cell trabecula to give a pseudopapillary appearance. A second type was concerned with tumor cell necrosis and subsequent pseudoglandular formation (6/39). A rare variant similar to papillary carcinoma was also seen in this group. Third, five cases showed microglandular formation in an scirrhous environment thereby resembling cholangiocarcinoma or metastatic adenocarcinomas. Despite these confusing features, the overall tumor histologic features, in particular the existence of a characteristic trabecular growth pattern made it possible to determine all of the cases as HCC. The importance of noticing these variable manifestations of HCC is yet emphasized in regard to differential diagnosis of hepatic tumors. The glandular elements seen in two cases of combined HCC and cholangiocarcinoma differed in that they were positive for mucin staining. In addition, the tumor cells contained mucin-positive intracytoplasmic vacuoles similar to those observed in common mucin producing adenocarcinomas.
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PMID:Pseudoglandular hepatocellular carcinoma. A morphogenetic study. 244 May 54

Combined hepatocellular-cholangiocarcinoma is a rare form of primary liver cancer showing features of both hepatocellular and biliary epithelial differentiation. In a review of 24 cases of this tumor, three histologic types were encountered. Four cases were Type I or "collision tumors," apparently a coincidental occurrence of both hepatocellular carcinoma and cholangiocarcinoma in the same patient. Twelve cases were Type II or "transitional tumors," in which there were areas of intermediate differentiation and an identifiable transition between hepatocellular carcinoma and cholangiocarcinoma. Eight cases were Type III or "fibrolamellar tumors" which resembled the fibrolamellar variant of hepatocellular carcinoma but which also contained mucin-producing pseudoglands. Type III tumors differ from other combined tumors, occurring at a younger age, in the absence of cirrhosis, and having a slightly longer survival. Immunohistochemical (immunoperoxidase) staining for intracellular antigens showed that alpha-fetoprotein is a fairly specific, although insensitive, marker of hepatocellular differentiation in primary liver cancers, being present in 50% of typical hepatocellular carcinomas and in hepatocellular areas in 29% of combined tumors, but in no cholangiocarcinomas or cholangiocellular areas of combined tumors. Keratin is a good marker of biliary epithelial differentiation, being found in 90% of cholangiocarcinomas and in 52% of combined hepatocellular cholangiocarcinomas, but in no hepatocellular carcinomas. Alpha-1-antitrypsin, fibrinogen, IgG, and carcinoembryonic antigen may be found in both hepatocellular carcinoma, cholangiocarcinoma, and in combined tumors; these antigens are therefore of limited use in differential diagnosis.
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PMID:Combined hepatocellular-cholangiocarcinoma. A histologic and immunohistochemical study. 257 78

Recent studies in animal models involving antibody tumor targeting of hepatoma and melanoma and clinical trials involving hepatoma patients have suggested that preirradiation of tumors may enhance antibody tumor targeting. These reports led us to study the effect of external irradiation on monoclonal antibody (MAb) targeting of human carcinomas; as a model system, we used MAb B72.3 and the LS-174T human colon carcinoma xenograft in athymic mice. LS-174T tumors exposed to 300 cGy grew to approximately 93% the size of non-irradiated tumors, while those exposed to 600, 900, or 2,000 cGy were approximately 41% the size of control tumors. Splitting the 900 cGy into three 300-cGy fractions yielded a two-fold lower tumor volume compared with a single 900-cGy fraction. Histochemical evaluation of the carcinomas revealed a decrease in the number of mitoses per high power field consistent with early effects of radiation exposure. Using the avidin-biotin complex immunoperoxidase technique, carcinomas were assayed for expression of the tumor associated glycoprotein (TAG)-72, the high-molecular-weight mucin detected by MAb B72.3. No discernable variation was observed in the staining intensity among tumors in both the control and radiation treated group; that is, differences among tumors within each group were compatible with the known heterogeneous expression of TAG-72. Exposure of carcinomas to 300 or 900 cGy in a single fraction or 900 cGy split in three 300-cGy fractions did not yield a consistent or substantial enhanced localization of radiolabeled MAb B72.3 IgG or F(ab')2 to tumors. A 1.5-fold augmentation of MAb binding to tumors was observed in preirradiated mice; however, these results were not statistically significant. Inherent differences in tumors such as cell type of origin, size, spatial configuration, extent of vascularization and volume of interstitial space may contribute to variability of the effect of preirradiation of tumors on antibody binding. Our results suggest that consistent augmentation of radiolabeled antibody localization to tumors is not a universal phenomenon.
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PMID:Studies concerning the effect of external irradiation on localization of radiolabeled monoclonal antibody B72.3 to human colon carcinoma xenografts. 292 Nov 70

A rare autopsy case of combined liver cell and bile duct carcinoma (CLBC) occurring in a 51-year-old male with alcoholic liver cirrhosis is presented. Histologically, while the primary lesion was solely composed of well differentiated hepatocellular carcinoma (HCC), intrahepatic metastases consisted of a variable admixture of HCC and cholangiocarcinoma (CC) with excessive mucin production. Interestingly, the tumor cell cluster showing a trabecular growth pattern produced both bile and mucin, thus converting from HCC to mucinous CC. It is concluded that this liver malignancy is principally HCC with a marked tendency to transform into CC. The importance of the findings, especially the simultaneous production of bile and mucin within the same cell cluster, is emphasized in terms of the classification of CLBCs.
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PMID:Combined hepatocellular and mucinous carcinoma. 301 Jun 33


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