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Update on hepatocellular carcinoma: Pathologists' review

World Journal of Gastroenterology 2019年第14期25卷 1653-1665页

作者： Tony El Jabbour stephen m lagana Hwajeong Lee Department of Pathology and Laboratory medicine Albany Medical College Department of Pathology and Cell Biology College of Physicians and Surgeons Columbia University

Histopathologic diversity and several distinct histologic subtypes of hepatocellular carcinoma(HCC) are well-recognized. Recent advances in molecular pathology and growing knowledge about the biology associated with distinct histologic features and immuno-profile in HCC allowed pathologists to update classifications. Improving sub-classification will allow for more clinically relevant diagnoses and may allow for stratification into biologically meaningful subgroups. Therefore, immuno-histochemical and molecular testing are not only diagnostically useful, but also are being incorporated as crucial components in predicting prognosis of the patients with HCC. Possibilities of targeted therapy are being explored in HCC, and it will be important for pathologists to provide any data that may be valuable from a theranostic perspective. Herein, we review and provide updates regarding the pathologic sub-classification of *** diagnostic approach and the role of biomarkers as prognosticators are reviewed. Further, the histopathology of four particular subtypes of HCC:Steatohepatitic, clear cell, fibrolamellar and scirrhous-and their clinical relevance, and the recent consensus on combined HCC-cholangiocarcinoma is summarized. Finally, emerging novel biomarkers and new approaches to HCC stratification are reviewed.

关键词： Hepatocellular carcinoma Subtype Classification Review Update

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Composite intestinal adenoma-microcarcinoid:An update and literature review

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World Journal of Gastrointestinal Endoscopy 2021年第12期13卷 593-606页

作者： Zhi-Yan Fu michel Kmeid mahmoud Aldyab stephen m lagana Hwajeong Lee Pathology and Laboratory medicine Albany Medical CenterAlbanyNY 12208United States Department of Pathology and Cell Biology Columbia University Irving Medical CenterNew YorkNY 10032United States

Composite intestinal adenoma-microcarcinoid(CIAm)is a rare intestinal lesion consisting of conventional adenoma and small,well differentiated carcinoid[microcarcinoid(mC)]at its *** incidence of CIAm is 3.8%in surgically resected colorectal *** its pathogenesis is unknown,studies support the role of Wnt/β-catenin pathway in the tumorigenesis of *** have been primarily reported in the colon wherein they present as polyps with well-defined margins,similar to conventional adenomatous *** is usually found in adenomatous polyps with high-risk features such as large size,villous architecture,or high grade ***,the mC component is often multifocal and spans 3.9 to 5.8 millimeters in *** is usually confined within the mucosa but occasional CIAm cases with mC extending to the submucosa have been *** of CIAm demonstrates bland cytology and inconspicuous proliferative *** lesional cells are positive for synaptophysin and 60%to 100%of cases show nuclearβ-catenin *** poses a diagnostic challenge with its morphologic and immunohistochemical resemblance to both benign and malignant lesions,including squamous morules/metaplasia,adenocarcinoma,squamous cell carcinoma,sporadic neuroendocrine tumor and goblet cell *** is an indolent lesion with a favorable *** removal by polypectomy is considered *** and recognition of this rare entity will help arrive at correct diagnosis and improve patient ***,CIAm is not recognized as a subtype of mixed neuroendocrine-nonneuroendocrine neoplasm by WHO.

关键词： Composite Adenoma microcarcinoid Composite intestinal adenomamicrocarcinoid Wnt/β-catenin mixed neuroendocrine-non-neuroendocrine neoplasm

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Current concepts in the immunohistochemical evaluation of liver tumors

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World Journal of Hepatology 2015年第10期7卷 1403-1411页

作者： Anne K Koehne de Gonzalez marcela A Salomao stephen m lagana Department of Pathology and Cell Biology College of Physicians and SurgeonsColumbia University

Immunohistochemistry often plays an important role in the evaluation of liver tumors. Recent advances have established a classification system for hepatocellular adenomas(HCAs) based on morphology,molecular alterations,and immunohistochemistry. Specifically,loss of liver fatty acid binding protein is seen in HNF1α-inactivated HCA,staining with serum amyloid A isseen in inflammatory HCA,and diffuse staining with glutamine synthetase(GS) is seen in β-catenin activated HCA. A panel of immunohistochemical stains including glypican-3(GPC-3),heat shock protein 70,and GS are useful in distinguishing HCC from non-malignant dysplastic nodules. Immunohistochemistry is also useful to determine whether a liver tumor is of primary hepatocellular or metastatic origin. Recently described markers useful for this purpose include arginase-1,GPC-3,and bile salt export pump. These newer markers may offer superior utility when compared to traditional markers of hepatocellular differentiation such as alpha-fetoprotein,hepatocyte paraffin-1,polyclonal carcinoembryonic antigen,and CD10. This paper will review recent advances in the immunohistochemical evaluation of liver tumors.

关键词： Immunohistochemistry Hepatocellularadenoma Focal nodular hyperplasia Hepatocellularcarcinoma

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