Quiz-summary
0 of 1 questions completed
Questions:
- 1
Information
Presented by Pedram Argani, M.D. and prepared by Shien Micchelli, M.D.
Case 3: 56 year old female with a solitary liver mass. There is no evidence of disease elsewhere.
You have already completed the quiz before. Hence you can not start it again.
Quiz is loading...
You must sign in or sign up to start the quiz.
You have to finish following quiz, to start this quiz:
Results
Time has elapsed
Categories
- Not categorized 0%
- 1
- Answered
- Review
-
Question 1 of 1
1. Question
Week 255: Case 3
56 year old female with a solitary liver mass. There is no evidence of disease elsewhere.images/1_30_06_3a.jpg
images/1_30_06_3b.jpg
images/1_30_06_3d.jpg
images/1_30_06_3c.jpg
images/1_30_06_3e.jpgCorrect
Answer: Mesothelioma
Histology: This is a solid, tubulo-papillary proliferation of polygonal epithelioid cells. The cells have round nuclei, granular pink cytoplasm, and well-defined cell borders. On immunohistochemical analysis, the tumor cells are immunoreactive for cytokeratin, non-immunoreactive for HEPAR-1, and strongly immunoreactive for Calretinin.
Discussion: Hepatocellular Carcinoma would demonstrate labeling for HEPAR-1, and show canalicular pattern labeling for polyclonal CEA. Interhepatic Cholangiocarcinoma would demonstrate diffuse labeling for polyclonal CEA, frequently contains intercellular mucin, and would not label for Calretinin. Epithelioid Hemangioendothelioma could mimic a primary hepatic epithelial neoplasm; however, this tumor typically features myxochondroid stroma, and vacuolated epithelioid endothelial cells that would label for CD34 and CD31.
Given that this was a localized lesion with no evidence of disease elsewhere in the peritoneum, this appears to be an example of Localized Malignant Mesothelioma. Many of these cases are cured by excision. Interestingly, when these tumors do metastasize, they spread hematogenously like a sarcoma, unlike typical diffuse malignant mesothelioma which typically involves serosal surfaces.
Reference(s):
– Am J Surg Pathol 2005; 29: 866-873.Incorrect
Answer: Mesothelioma
Histology: This is a solid, tubulo-papillary proliferation of polygonal epithelioid cells. The cells have round nuclei, granular pink cytoplasm, and well-defined cell borders. On immunohistochemical analysis, the tumor cells are immunoreactive for cytokeratin, non-immunoreactive for HEPAR-1, and strongly immunoreactive for Calretinin.
Discussion: Hepatocellular Carcinoma would demonstrate labeling for HEPAR-1, and show canalicular pattern labeling for polyclonal CEA. Interhepatic Cholangiocarcinoma would demonstrate diffuse labeling for polyclonal CEA, frequently contains intercellular mucin, and would not label for Calretinin. Epithelioid Hemangioendothelioma could mimic a primary hepatic epithelial neoplasm; however, this tumor typically features myxochondroid stroma, and vacuolated epithelioid endothelial cells that would label for CD34 and CD31.
Given that this was a localized lesion with no evidence of disease elsewhere in the peritoneum, this appears to be an example of Localized Malignant Mesothelioma. Many of these cases are cured by excision. Interestingly, when these tumors do metastasize, they spread hematogenously like a sarcoma, unlike typical diffuse malignant mesothelioma which typically involves serosal surfaces.
Reference(s):
– Am J Surg Pathol 2005; 29: 866-873.
