A mixed hepatocellular carcinoma and cholangiocarcinoma: dual expression of biliary-type cytokeratin and hepatocyte specific marker.
A 5-cm lesion in the right hepatic lobe was detected in a 61-year-old man with chronic hepatitis C by ultrasonography. Contrast-enhanced computed tomography showed a low-density lesion with wide peripheral enhancement. Hepatic angiography revealed that the tumor had partial hypervascularity. Although serum concentrations of alpha-fetoprotein and carcinoembryonic antigen were within normal limits, an elevated concentration of carcinohydrate antigen 19-9 was detected in serum. A definitive diagnosis was not made although we strongly suspected mixed hepatocellular carcinoma and cholangiocarcinoma. Since intraoperative frozen-section examination revealed adenocarcinoma, a right hepatic lobectomy with regional lymph node dissection was performed. A histologic diagnosis of mixed hepatocellular carcinoma and cholangiocarcinoma was made because the hepatic tumor consisted of components of both hepatocellular carcinoma and cholangiocellular carcinoma, with a transitional area. Additionally, immunohistochemical examination revealed that some tumor cells in the transitional area were immunoreactive for both cytokeratin 19 and hepatocyte paraffin 1.
Tanaka
Shogo
S
Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan. m8827074@msic.med.osaka-cu.ac.jp
Hirohashi
Kazuhiro
K
Uenishi
Takahiro
T
Yamamoto
Takatsugu
T
Hamba
Hiroyuki
H
Kubo
Shoji
S
Tanaka
Hiromu
H
Shuto
Taichi
T
Ogawa
Masao
M
Kinoshita
Hiroaki
H
D001650:Bile Duct Neoplasms / Q000378:metabolism*; D001653:Bile Ducts, Intrahepatic; D014408:Biomarkers, Tumor / Q000096:biosynthesis; D006528:Carcinoma, Hepatocellular / Q000378:metabolism*; D018281:Cholangiocarcinoma / Q000378:metabolism*; D022781:Hepatocytes / Q000378:metabolism; D006801:Humans; D007633:Keratins / Q000096:biosynthesis; D008113:Liver Neoplasms / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000378:metabolism*
D014408:Biomarkers, Tumor; D007633:Keratins