Coelho Rosa, Gonçalves Regina, Carneiro Fátima, Fernandes Margarida, Lopes Joanne, Guimarães Susana, Macedo Guilherme
Gastroenterology Department, Centro Hospitalar São João, Porto. Portugal.
Pathology Department, Centro Hospitalar São João, Porto. Portugal; IPATIMUP, Institute of Molecular Pathology and Immunology of the University of Porto, Porto. Portugal.
Ann Hepatol. 2016 Jul-Aug;15(4):598-603.
Hepatocellular adenomas (HCAs) are benign liver tumors recently characterized into 4 different types according to genetic, pathological and clinical features. The prognosis is not well established yet and malignant transformation has been recently associated with β-catenin activation. We aimed to describe a case of a pigmented HCA with β-catenin nuclear expression and inflammatory features and to review the cases of pigmented HCAs in the literature. We report a case of a young female patient without contraceptive use, with a liver tumor diagnosis. Liver biopsy revealed diffuse expression of β-catenin and a partial hepatic resection was performed. The histologic analysis revealed a hepatocellular tumor composed of uniform trabeculae of hepatocytes and solid areas, the later with a significant amount of black pigment highlighted by Masson-Fontana stain. Immunohistochemistry showed co-expression of C-reactive protein and serum amyloid A in the tumor. Literature review revealed that pigmented HCAs, previously reported as dark adenomas, are rare tumors. In HCAs, the presence of β-catenin activation should be searched for due to the higher risk of malignant transformation in hepatocarcinoma. We describe a pigmented HCA with β-catenin nuclear expression and inflammatory features being the fifth case reported so far.
肝细胞腺瘤（HCAs）是一种良性肝脏肿瘤，最近根据基因、病理和临床特征被分为4种不同类型。其预后尚未完全明确，且恶性转化最近被认为与β-连环蛋白激活有关。我们旨在描述一例具有β-连环蛋白核表达和炎症特征的色素沉着型HCA病例，并回顾文献中色素沉着型HCA的病例。我们报告一例年轻女性患者，未使用避孕药，被诊断为肝脏肿瘤。肝脏活检显示β-连环蛋白弥漫性表达，并进行了部分肝切除术。组织学分析显示，肝细胞肿瘤由均匀的肝细胞小梁和实性区域组成，后者经Masson-Fontana染色显示有大量黑色色素。免疫组化显示肿瘤中C反应蛋白和血清淀粉样蛋白A共表达。文献回顾显示，色素沉着型HCA，以前称为深色腺瘤，是罕见肿瘤。在HCA中，由于肝细胞癌发生恶性转化的风险较高，应寻找β-连环蛋白激活的存在情况。我们描述了一例具有β-连环蛋白核表达和炎症特征的色素沉着型HCA，这是迄今为止报道的第五例。
