Thyroid-like cholangiocarcinoma of the liver: an unusual morphologic variant with follicular, trabecular and insular patterns
We report the case of a 26-year-old woman with a 19 cm malignant hepatic neoplasm with morphological features that closely resembled a follicular thyroid carcinoma. Despite this, it was interpreted as a cholangiocarcinoma due to the absence of a primary thyroid tumor and the lack of thyroglobulin an...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2012-11-01
|
| Series: | Annals of Hepatology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268119314279 |
| _version_ | 1818588279582228480 |
|---|---|
| author | Fredy Chablé-Montero, MD Amy Shah BS Daniel Montante-Montes de Oca Arturo Ángeles-Ángeles Donald E. Henson Jorge Albores-Saavedra |
| author_facet | Fredy Chablé-Montero, MD Amy Shah BS Daniel Montante-Montes de Oca Arturo Ángeles-Ángeles Donald E. Henson Jorge Albores-Saavedra |
| author_sort | Fredy Chablé-Montero, MD |
| collection | DOAJ |
| description | We report the case of a 26-year-old woman with a 19 cm malignant hepatic neoplasm with morphological features that closely resembled a follicular thyroid carcinoma. Despite this, it was interpreted as a cholangiocarcinoma due to the absence of a primary thyroid tumor and the lack of thyroglobulin and TTF-1 immunoreactivity by the hepatic tumor. The left hepatic lobectomy specimen showed an encapsulated and multinodular gray-white mass with cystic and hemorrhagic areas. Microscopically, it displayed predominant macro and microfolicullar patterns with focal solid, trabecular and insular areas. The small and distended follicles contained a colloid-like secretion and were lined by low cuboidal cells with scant cytoplasm, round or oval hyperchromatic nuclei with fine chromatin. The solid areas, trabecular and insular structures were similar to those of follicular or papillary thyroid carcinomas. In addition, some of the neoplastic cells had clear nuclei with occasional grooves. The tumor was positive for cytokeratin (CK) 7, CK 19 and CD138, and negative for TTF-1, thyroglobulin, Hepar-1, Glypican-3, alpha-fetoprotein and neuroendocrine markers. A thyroid neoplasm was excluded clinically and by ultrasound and computed tomography. Although, the residual hepatic parenchyma was initially not cirrhotic, the patient eventually developed cryptogenic cirrhosis. The patient received adjuvant chemotherapy and died of metastatic disease 18 months after surgery. The thyroid-like pattern broadens the morphologic spectrum of cholangiocarcinoma. |
| first_indexed | 2024-12-16T09:22:14Z |
| format | Article |
| id | doaj.art-9bf684bb9e0d4ea2b54203dcab7bef53 |
| institution | Directory Open Access Journal |
| issn | 1665-2681 |
| language | English |
| last_indexed | 2024-12-16T09:22:14Z |
| publishDate | 2012-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Annals of Hepatology |
| spelling | doaj.art-9bf684bb9e0d4ea2b54203dcab7bef532022-12-21T22:36:45ZengElsevierAnnals of Hepatology1665-26812012-11-01116961965Thyroid-like cholangiocarcinoma of the liver: an unusual morphologic variant with follicular, trabecular and insular patternsFredy Chablé-Montero, MD0Amy Shah BS1Daniel Montante-Montes de Oca2Arturo Ángeles-Ángeles3Donald E. Henson4Jorge Albores-Saavedra5Department of Pathology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico; Correspondence and reprint request: Fredy Chablé Montero, MD. Department of Pathology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Vasco de Quiroga, Núm. 15, Col. Sección XVI, Tlalpan, México D.F. C.P. 14000 E-mail:Department of Pathology of Medica Sur Clinic and Foundation, Mexico City, MexicoGeorge Washington University Cancer Institute, Washington DC. USADepartment of Pathology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoDepartment of Pathology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoGeorge Washington University Cancer Institute, Washington DC. USAWe report the case of a 26-year-old woman with a 19 cm malignant hepatic neoplasm with morphological features that closely resembled a follicular thyroid carcinoma. Despite this, it was interpreted as a cholangiocarcinoma due to the absence of a primary thyroid tumor and the lack of thyroglobulin and TTF-1 immunoreactivity by the hepatic tumor. The left hepatic lobectomy specimen showed an encapsulated and multinodular gray-white mass with cystic and hemorrhagic areas. Microscopically, it displayed predominant macro and microfolicullar patterns with focal solid, trabecular and insular areas. The small and distended follicles contained a colloid-like secretion and were lined by low cuboidal cells with scant cytoplasm, round or oval hyperchromatic nuclei with fine chromatin. The solid areas, trabecular and insular structures were similar to those of follicular or papillary thyroid carcinomas. In addition, some of the neoplastic cells had clear nuclei with occasional grooves. The tumor was positive for cytokeratin (CK) 7, CK 19 and CD138, and negative for TTF-1, thyroglobulin, Hepar-1, Glypican-3, alpha-fetoprotein and neuroendocrine markers. A thyroid neoplasm was excluded clinically and by ultrasound and computed tomography. Although, the residual hepatic parenchyma was initially not cirrhotic, the patient eventually developed cryptogenic cirrhosis. The patient received adjuvant chemotherapy and died of metastatic disease 18 months after surgery. The thyroid-like pattern broadens the morphologic spectrum of cholangiocarcinoma.http://www.sciencedirect.com/science/article/pii/S1665268119314279Thyroid-like patternHepatocellular carcinomaHepar-1TTF-1Thyroglobulin |
| spellingShingle | Fredy Chablé-Montero, MD Amy Shah BS Daniel Montante-Montes de Oca Arturo Ángeles-Ángeles Donald E. Henson Jorge Albores-Saavedra Thyroid-like cholangiocarcinoma of the liver: an unusual morphologic variant with follicular, trabecular and insular patterns Annals of Hepatology Thyroid-like pattern Hepatocellular carcinoma Hepar-1 TTF-1 Thyroglobulin |
| title | Thyroid-like cholangiocarcinoma of the liver: an unusual morphologic variant with follicular, trabecular and insular patterns |
| title_full | Thyroid-like cholangiocarcinoma of the liver: an unusual morphologic variant with follicular, trabecular and insular patterns |
| title_fullStr | Thyroid-like cholangiocarcinoma of the liver: an unusual morphologic variant with follicular, trabecular and insular patterns |
| title_full_unstemmed | Thyroid-like cholangiocarcinoma of the liver: an unusual morphologic variant with follicular, trabecular and insular patterns |
| title_short | Thyroid-like cholangiocarcinoma of the liver: an unusual morphologic variant with follicular, trabecular and insular patterns |
| title_sort | thyroid like cholangiocarcinoma of the liver an unusual morphologic variant with follicular trabecular and insular patterns |
| topic | Thyroid-like pattern Hepatocellular carcinoma Hepar-1 TTF-1 Thyroglobulin |
| url | http://www.sciencedirect.com/science/article/pii/S1665268119314279 |
| work_keys_str_mv | AT fredychablemonteromd thyroidlikecholangiocarcinomaoftheliveranunusualmorphologicvariantwithfolliculartrabecularandinsularpatterns AT amyshahbs thyroidlikecholangiocarcinomaoftheliveranunusualmorphologicvariantwithfolliculartrabecularandinsularpatterns AT danielmontantemontesdeoca thyroidlikecholangiocarcinomaoftheliveranunusualmorphologicvariantwithfolliculartrabecularandinsularpatterns AT arturoangelesangeles thyroidlikecholangiocarcinomaoftheliveranunusualmorphologicvariantwithfolliculartrabecularandinsularpatterns AT donaldehenson thyroidlikecholangiocarcinomaoftheliveranunusualmorphologicvariantwithfolliculartrabecularandinsularpatterns AT jorgealboressaavedra thyroidlikecholangiocarcinomaoftheliveranunusualmorphologicvariantwithfolliculartrabecularandinsularpatterns |