title: Fibrolamellar carcinoma versus scirrhous hepatocellular carcinoma : diagnostic usefulness of CD68.
abstract: BACKGROUND
  Fibrolamellar hepatocellular carcinoma (FL-HCC) is a rare variant of hepatocellular carcinoma that commonly affects young individuals without a prior history of liver disease. The principal differential diagnosis is conventional hepatocellular carcinoma especially the scirrhous variant. Despite their distinctive appearance, recent studies have demonstrated a lack of consistency in how FL-HCC are diagnosed by pathologists.
  
  
  OBJECTIVE
  To investigate the diagnostic utility of CD68 in differentiating between FL-HCC and scirrhous hepatocellular carcinoma.
  
  
  METHODS
  In our retrospective study, we reviewed four cases of FL-HCC that were diagnosed at the pathology department of Mongi Slim hospital over a thirteen-year period (2002-2014). Relevant clinical information and microscopic slides were available in all cases and were retrospectively reviewed. Immunohistochemical analysis was performed using the avidin-biotin complex technique with antibodies against CD68 and CK7.
  
  
  RESULTS
  Our study group included one man and three women (sex ratio M/F=0.33) aged between 23 and 34 years (mean=28 years). All cases arose in non-cirrhotic liver. Immunohistochemically, all cases were positive for CK7 and for CD68 (n=4).
  
  
  CONCLUSIONS
  CD68 immunostaining is a sensitive marker for FL-HCC that may be of use in routine diagnostic surgical pathology. Lack of CD68 staining should suggest caution in making a diagnosis of FL-HCC.
authors.forename: Faten
authors.initials: F
authors.lastname: Limaiem
authors.forename: Saadia
authors.initials: S
authors.lastname: Bouraoui
authors.forename: Maroua
authors.initials: M
authors.lastname: Sboui
authors.forename: Sirine
authors.initials: S
authors.lastname: Bouslama
authors.forename: Ahlem
authors.initials: A
authors.lastname: Lahmar
authors.forename: Sabeh
authors.initials: S
authors.lastname: Mzabi
mesh_terms: D002293:Adenocarcinoma, Scirrhous / Q000175:diagnosis* / Q000378:metabolism; D000328:Adult; D015703:Antigens, CD / Q000378:metabolism*; D015214:Antigens, Differentiation, Myelomonocytic / Q000378:metabolism*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000378:metabolism; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000378:metabolism*; D008297:Male; D055815:Young Adult; D000097382:CD68 Molecule
chemical_list: D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; C067980:CD68 antigen, human; D000097382:CD68 Molecule