Choi Won-Tak, Kakar Sanjay
Department of Pathology, University of California at San Francisco, 505 Parnassus Avenue, M552, Box 0102, San Francisco, CA 94143, USA.
Department of Pathology, University of California at San Francisco, 505 Parnassus Avenue, M543, Box 0102, San Francisco, CA 94143, USA.
Gastroenterol Clin North Am. 2017 Jun;46(2):311-325. doi: 10.1016/j.gtc.2017.01.006.
Hepatocellular carcinoma (HCC) can be difficult to distinguish from its mimics, including metastatic tumor, benign hepatocellular lesion, and high-grade dysplastic nodule, especially when limited biopsy material is available. Hence, the judicious use of immunohistochemical stains is necessary to establish a correct diagnosis. This article describes advantages and disadvantages of immunohistochemical markers that are most commonly used to distinguish between these lesions. Diagnostic workup of malignant liver mass (HCC and its histologic variants vs metastatic tumor) as well as well-differentiated hepatocellular lesion (well-differentiated HCC vs focal nodular hyperplasia vs hepatocellular adenoma) is also discussed.
肝细胞癌(HCC)可能难以与其类似病变相鉴别,这些类似病变包括转移瘤、良性肝细胞病变和高级别发育异常结节,尤其是在活检材料有限的情况下。因此,明智地使用免疫组织化学染色对于做出正确诊断是必要的。本文描述了最常用于区分这些病变的免疫组织化学标志物的优缺点。还讨论了恶性肝肿块(HCC及其组织学变体与转移瘤)以及高分化肝细胞病变(高分化HCC与局灶性结节性增生与肝细胞腺瘤)的诊断检查。