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Clinicopathological characteristics in the differential diagnosis of hepatoid adenocarcinoma:A literature review

World Journal of Gastroenterology 2013年第3期19卷 321-327页

作者： Jiann-Sheng Su Yu-Tso Chen Ren-Ching Wang Chun-Ying Wu Shou-Wu Lee Teng-Yu Lee Division of Gastroenterology and Hepatology Kuang Tien General Hospital Division of Gastroenterology and Hepatology Taichung VeteransGeneral Hospital Department of Pathology and LaboratoryMedicine Taichung Veterans General Hospital Graduate Institute of Clinical Medical Science China Medical University Department of Medicine Chung Shan Medical University Division of Gastroenterology and Hepatology Taichung Veterans General Hospital

Hepatoid adenocarcinoma (HAC) is a rare but important special type of extrahepatic adenocarcinoma with clinicopathological presentation mimicking hepatocellular carcinoma (HCC), and prompt and correct diagnosis can be a challenge, especially in endemic areas with a high incidence of HCC. To date, HAC has only been reported in case series or single case reports, so we aimed to review the clinicopathological characteristics of HAC to obtain a more complete picture of this rare form of extrahepatic adenocarcinoma. All the articles about HAC published from 2001 to 2011 were reviewed, and clinicopathological findings were extracted for analysis. A late middle-aged male with high serum α-fetoprotein and atypical image finding of HCC should raise the suspicion of HAC, and characteristic pathological immunohistochemical stains can help with the differential diagnosis. Novel immunohistochemical markers may be useful to clearly differentiate HAC from HCC. Once metastatic HAC is diagnosed, the primary tumor origin should be identified for adequate treatment. The majority of HAC originates from the stomach, so panendoscopy should be arranged first.

关键词： Hepatocellular carcinoma Alpha-fetopro-tein-producing tumor Alpha fetoprotein Gastric adeno-carcinoma Pathology

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adenocarcinoma of the third and fourth portions of the duodenum: The capsule endoscopy value

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World Journal of Gastroenterology 2015年第31期21卷 9437-9441页

作者： Feliciano Chanana Paquissi Ana Henriqueta Filipe Bunga Pimentel Lima Maria de Fátima do Nascimento Vieira Lopes Francisco Viamontes Diaz Department of Medicine Clínica GirassolLuanda 1215Angola Service of Clinical Pathology Clínica GirassolLuanda 1215Angola Service of Gastroenterology Clínica GirassolLuanda 1215Angola Department of General Surgery Clínica GirassolLuanda 1215Angola

Primary adenocarcinoma of the small intestine occurs in over 50% of cases in the duodenum. However,its location in the third and fourth duodenal portions occurs rarely and is a diagnostic challenge. The aim of this work is to report an adenocarcinoma of the third and fourth duodenal portions,emphasizing its diagnostic difficulty and the value of video capsule endoscopy. A man,40 years old,with no medical history,with abdominal discomfort and progressive fatigue,presented four months ago with one episode o f m o d e ra t e m e l e n a. T h e p hy s i c a l e x a m i n a t i o n was normal,except for mucosal pallor. Blood tests were consistent with microcytic,hypochromic iron deficiency anemia with 7.8 g/d L hemoglobin. The upper and lower endoscopy were normal. Additional work-up with video capsule endoscopy showed a polypoid lesion involving the third and fourth portions o f t h e d u o d e n u m. B i o p s y s h o w e d a m o d e ra t e l y differentiated adenocarcinoma. Abdominal computed tomography showed a wall thickening from the third duodenal portion to the proximal jejunum,without distant metastasis. The patient underwent segmental resection(distal duodenum and proximal jejunum) with duodenojejunostomy. The surgical specimen histology confirmed the biopsy diagnosis,with transmural infiltration,without nodal involvement. Conclusion: adenocarcinoma of the third and fourth portions of the duodenum is difficult to diagnose and capsule endoscopy is of great value.

关键词： Duodenum Duodenal cancer adeno-carcinoma Endoscopy

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Coexpression of receptor-tyrosine-kinases in gastric adenocarcinoma-a rationale for a molecular targeting strategy?

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World Journal of Gastroenterology 2007年第26期13卷 3605-3609页

作者： Daniel Drescher Markus Moehler Ines Gockel Kirsten Frerichs Annett Müller Friedrich Dünschede Thomas Borschitz Stefan Biesterfeld Martin Holtmann Thomas Wehler Andreas Teufel Kerstin Herzer Thomas Fischer Martin R Berger Theodor Junginger Peter R Galle Carl C Schimanski Department of General and Abdominal Surgery Johannes Gutenberg University of Mainz MainzGermany First Department of Internal Medicine Johannes Gutenberg University of Mainz MainzGermany Institute of Pathology Johannes Gutenberg University of MainzMainzGermany Third Department of Internal Medicine Johannes Gutenberg University of Mainz MainzGermany Unit of toxicology and chemotherapy German Cancer Research CenterGermany

AIM： To define the （co-）expression pattern of target receptor-tyrosine-kinases （RTK） in human gastric adenocarcinoma. METHODS： The （co-）expression pattern of VEGFR1-3, PDGFR（α/β and EGFR1 was analyzed by RT-PCR in 51 human gastric adenocarcinomas. In addition, IHC staining was applied for confirmation of expression and analysis of RTK localisation. RESULTS： The majority of samples revealed a VEGFR1 （98%）, VEGFR2 （80%）, VEGFR3 （67%）, PDGFRα （82%） and PDGFRβ （82%） expression, whereas only 62% exhibited an EGFR1 expression. 78% of cancers expressed at least four out of six RTKs. While VEGFR1-3 and PDGFRα revealed a predominantly cytoplasmatic staining in tumor cells, accompanied by an additional nuclear staining for VEGFR3, EGFR1 was almost exclusively detected on the membrane of tumor cells. PDGFRβ was restricted to stromal pericytes, which also depicted a PDGFRα expression. CONCLUSION： Our results reveal a high rate ofreceptor-tyrosine-kinases coexpression in gastric adenocarcinoma and might therefore encourage an application of multiple-target RTK-inhibitors within a combination therapy.

关键词： VEGFR EGFR PDGFR Cancer adeno-carcinoma Gastric Stomach

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