A de novo unclassified malignant spindle cell neoplasm of liver allograft.
Spindle cell neoplasms are rarely reported in liver allografts; most are benign and associated with Epstein-Barr virus infection. We present a case of a malignant spindle cell neoplasm arising in a liver allograft. The patient underwent orthotopic liver transplant for cirrhosis secondary to nonalcoholic steatohepatitis. After 2 years, he presented with vague abdominal complaints. Imaging studies revealed a 10-cm right hepatic lobe mass. The patient underwent right-sided hepatectomy. The tumor displayed areas of broad, relatively hypocellular fascicles, whorls, and perivascular clustering; spindle cells with mild to moderate nuclear pleomorphism; and relatively abundant eosinophilic cytoplasm. Mitotic activity ranged from 2 to 4 mitotic figures per 20 high-power fields. Immunostaining displayed positivity for epithelial membrane antigen, vimentin, CD99, BCL2, cytokeratin, and human herpesvirus 8. Interphase fluorescence in situ hybridization findings were negative for a translocation involving the SS18 gene (18q11). We believe the tumor represents the first reported case of a novel unclassified spindle cell malignant neoplasm in a liver allograft.
From the Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis.
Jessica A
JA
Clevenger
Romil
R
Saxena
Muhammad T
MT
Idrees
D015746:Abdominal Pain / Q000209:etiology; D000368:Aged; D002544:Cerebral Infarction / Q000150:complications; D017809:Fatal Outcome; D006660:Histoplasmosis / Q000150:complications / Q000276:immunology / Q000503:physiopathology; D006801:Humans; D016867:Immunocompromised Host; D008099:Liver / Q000276:immunology / Q000473:pathology* / Q000601:surgery; D008100:Liver Abscess / Q000150:complications; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D009102:Multiple Organ Failure / Q000150:complications / Q000209:etiology; D011183:Postoperative Complications / Q000175:diagnosis* / Q000276:immunology / Q000503:physiopathology / Q000601:surgery; D012509:Sarcoma / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology / Q000601:surgery; D014184:Transplantation, Homologous