Relevance of morphological features for hepatocellular adenoma classification in pathology practice
Abstract Background Gene mutations correlated with histological and immunohistochemical phenotypes of hepatocellular adenoma were recently identified. Based on these findings, four adenoma subtypes were distinguished. We classify hepatocellular adenoma (HCA) into subtypes based on histologic and imm...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-03-01
|
| Series: | Surgical and Experimental Pathology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s42047-020-00061-4 |
| _version_ | 1819208339216662528 |
|---|---|
| author | Carla Henriques Agostini Osmar Damasceno Ribeiro Arlete Fernandes Adriana Caroli-Bottino Vera Lucia Pannain |
| author_facet | Carla Henriques Agostini Osmar Damasceno Ribeiro Arlete Fernandes Adriana Caroli-Bottino Vera Lucia Pannain |
| author_sort | Carla Henriques Agostini |
| collection | DOAJ |
| description | Abstract Background Gene mutations correlated with histological and immunohistochemical phenotypes of hepatocellular adenoma were recently identified. Based on these findings, four adenoma subtypes were distinguished. We classify hepatocellular adenoma (HCA) into subtypes based on histologic and immunohistochemical findings and verify the contribution of histological features in pathology practice. Methods Thirty hepatocellular adenomas were classified in subtypes. Sinusoidal dilatation, ductular reaction, pseudoportal tracts, pseudoglands, steatosis, inflammatory infiltrate and cellular atypia were analyzed, as well as liver fatty acid binding protein, β catenin, serum amyloid A, glutamine synthetase, and C-reactive protein antibodies. Results Histologically, eleven adenomas were classified as HNF1A inactivated (HHCA), five were β-catenin-activated (bHCA) and fourteen were inflammatory adenoma (IHCA). Steatosis was found in all HHCA and was predominantly severe. Sinusoidal dilatation and inflammatory infiltrate were present in all IHCA. Ductular reaction, pseudoportal tracts and cellular atypia were observed in 71.4, 85.7 and 42.8%, respectively. Pseudoglands were present in 60% and cellular atypia in 80% of bHCA. According to immunohistochemistry, 11 were HHCA; 1 was bHCA; 17 were IHCA, among which 5 were β-catenin activated IHCA; and 1 was unclassified UHCA (UHCA). Superior concordance between the histological and immunohistochemical classifications was found for HHCA (К = 0.854) and IHCA (К = 0.657). Conclusion Approximately 90% of adenomas may be diagnosed by subgroup based only on morphological features. When aberrant β catenin nuclear staining is not found, glutamine synthetase positivity is useful for diagnosis, although supplementary molecular analysis may be necessary. |
| first_indexed | 2024-12-23T05:37:49Z |
| format | Article |
| id | doaj.art-cd3b848ca6da499d9408b74105cb5e96 |
| institution | Directory Open Access Journal |
| issn | 2520-8454 |
| language | English |
| last_indexed | 2024-12-23T05:37:49Z |
| publishDate | 2020-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Surgical and Experimental Pathology |
| spelling | doaj.art-cd3b848ca6da499d9408b74105cb5e962022-12-21T17:58:17ZengBMCSurgical and Experimental Pathology2520-84542020-03-01311710.1186/s42047-020-00061-4Relevance of morphological features for hepatocellular adenoma classification in pathology practiceCarla Henriques Agostini0Osmar Damasceno Ribeiro1Arlete Fernandes2Adriana Caroli-Bottino3Vera Lucia Pannain4Department of Pathology, School of Medicine, Federal University of Rio de JaneiroDepartment of Pathology, School of Medicine, Federal University of Rio de JaneiroDepartment of Pathology, School of Medicine, Federal University of Rio de JaneiroDepartment of Pathology, School of Medicine, Federal University of Rio de JaneiroDepartment of Pathology, School of Medicine, Federal University of Rio de JaneiroAbstract Background Gene mutations correlated with histological and immunohistochemical phenotypes of hepatocellular adenoma were recently identified. Based on these findings, four adenoma subtypes were distinguished. We classify hepatocellular adenoma (HCA) into subtypes based on histologic and immunohistochemical findings and verify the contribution of histological features in pathology practice. Methods Thirty hepatocellular adenomas were classified in subtypes. Sinusoidal dilatation, ductular reaction, pseudoportal tracts, pseudoglands, steatosis, inflammatory infiltrate and cellular atypia were analyzed, as well as liver fatty acid binding protein, β catenin, serum amyloid A, glutamine synthetase, and C-reactive protein antibodies. Results Histologically, eleven adenomas were classified as HNF1A inactivated (HHCA), five were β-catenin-activated (bHCA) and fourteen were inflammatory adenoma (IHCA). Steatosis was found in all HHCA and was predominantly severe. Sinusoidal dilatation and inflammatory infiltrate were present in all IHCA. Ductular reaction, pseudoportal tracts and cellular atypia were observed in 71.4, 85.7 and 42.8%, respectively. Pseudoglands were present in 60% and cellular atypia in 80% of bHCA. According to immunohistochemistry, 11 were HHCA; 1 was bHCA; 17 were IHCA, among which 5 were β-catenin activated IHCA; and 1 was unclassified UHCA (UHCA). Superior concordance between the histological and immunohistochemical classifications was found for HHCA (К = 0.854) and IHCA (К = 0.657). Conclusion Approximately 90% of adenomas may be diagnosed by subgroup based only on morphological features. When aberrant β catenin nuclear staining is not found, glutamine synthetase positivity is useful for diagnosis, although supplementary molecular analysis may be necessary.http://link.springer.com/article/10.1186/s42047-020-00061-4Hepatocellular adenomaMorphologyImmunohistochemistryPathology |
| spellingShingle | Carla Henriques Agostini Osmar Damasceno Ribeiro Arlete Fernandes Adriana Caroli-Bottino Vera Lucia Pannain Relevance of morphological features for hepatocellular adenoma classification in pathology practice Surgical and Experimental Pathology Hepatocellular adenoma Morphology Immunohistochemistry Pathology |
| title | Relevance of morphological features for hepatocellular adenoma classification in pathology practice |
| title_full | Relevance of morphological features for hepatocellular adenoma classification in pathology practice |
| title_fullStr | Relevance of morphological features for hepatocellular adenoma classification in pathology practice |
| title_full_unstemmed | Relevance of morphological features for hepatocellular adenoma classification in pathology practice |
| title_short | Relevance of morphological features for hepatocellular adenoma classification in pathology practice |
| title_sort | relevance of morphological features for hepatocellular adenoma classification in pathology practice |
| topic | Hepatocellular adenoma Morphology Immunohistochemistry Pathology |
| url | http://link.springer.com/article/10.1186/s42047-020-00061-4 |
| work_keys_str_mv | AT carlahenriquesagostini relevanceofmorphologicalfeaturesforhepatocellularadenomaclassificationinpathologypractice AT osmardamascenoribeiro relevanceofmorphologicalfeaturesforhepatocellularadenomaclassificationinpathologypractice AT arletefernandes relevanceofmorphologicalfeaturesforhepatocellularadenomaclassificationinpathologypractice AT adrianacarolibottino relevanceofmorphologicalfeaturesforhepatocellularadenomaclassificationinpathologypractice AT veraluciapannain relevanceofmorphologicalfeaturesforhepatocellularadenomaclassificationinpathologypractice |