Thyroid-like cholangiocarcinoma of the liver: an unusual morphologic variant with follicular, trabecular and insular patterns



Título del documento: Thyroid-like cholangiocarcinoma of the liver: an unusual morphologic variant with follicular, trabecular and insular patterns
Revista: Annals of hepatology
Base de datos: PERIÓDICA
Número de sistema: 000417700
ISSN: 1665-2681
Autors: 1
2
1
1
2
1
Institucions: 1Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Departamento de Patología, México, Distrito Federal. México
2George Washington University, Cancer Institute, Washington, Distrito de Columbia. Estados Unidos de América
Any:
Període: Nov-Dic
Volum: 11
Número: 6
Paginació: 961-965
País: México
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Caso clínico, analítico
Resumen en inglés We report the case of a 26-year-old woman with a 19 cm malignant hepatic neoplasm with morphological features that closely resembled a follicular thyroid carcinoma. Despite this, it was interpreted as a cholangiocarcinoma due to the absence of a primary thyroid tumor and the lack of thyroglobulin and TTF-1 immunoreactivity by the hepatic tumor. The left hepatic lobectomy specimen showed an encapsulated and multinodular gray-white mass with cystic and hemorrhagic areas. Microscopically, it displayed predominant macro and microfolicullar patterns with focal solid, trabecular and insular areas. The small and distended follicles contained a colloid-like secretion and were lined by low cuboidal cells with scant cytoplasm, round or oval hyperchromatic nuclei with fine chromatin. The solid areas, trabecular and insular structures were similar to those of follicular or papillary thyroid carcinomas. In addition, some of the neoplastic cells had clear nuclei with occasional grooves. The tumor was positive for cytokeratin (CK) 7, CK 19 and CD138, and negative for TTF-1, thyroglobulin, Hepar-1, Glypican-3, alpha-fetoprotein and neuroendocrine markers. A thyroid neoplasm was excluded clinically and by ultrasound and computed tomography. Although, the residual hepatic parenchyma was initially not cirrhotic, the patient eventually developed cryptogenic cirrhosis. The patient received adjuvant chemotherapy and died of metastatic disease 18 months after surgery. The thyroid-like pattern broadens the morphologic spectrum of cholangiocarcinoma
Disciplines Medicina
Paraules clau: Gastroenterología,
Oncología,
Diagnóstico,
Carcinoma hepatocelular,
Tiroglobulina,
Colangiocarcinoma,
Morfología
Keyword: Gastroenterology,
Oncology,
Diagnosis,
Hepatocellular carcinoma,
Thyroglobulin,
Cholangiocarcinoma,
Morphology
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