Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA.
Department of Pathology, The Johns Hopkins Hospital, Baltimore, MD.
Am J Clin Pathol. 2019 Jan 7;151(2):226-230. doi: 10.1093/ajcp/aqy134.
It is challenging to separate peritumoral fibrosis from fibrosis due to chronic liver disease in mass-directed liver biopsies. We evaluated the distance that peritumoral fibrosis extends from metastatic colorectal adenocarcinoma in liver.
Peritumoral and distant uninvolved liver trichrome stains from 25 cases were analyzed using digital image analysis. Fibrosis was quantitated at concentric intervals from each tumor and in uninvolved liver.
There was a 3.9 fold (range 0.9-18.6) median increase in fibrosis in the first 0.5 mm of peritumoral liver compared to distant liver. Fibrosis levels returned to baseline at median 2.5 mm (interquartile range 1.5-5.0 mm) from tumor.
Fibrosis is markedly increased in peritumoral liver. Fibrosis levels returned to baseline by 5 mm from tumor in approximately 75% of cases. Pathologists should be cautious of fibrosis in mass-directed liver biopsies without at least 5 mm of liver tissue distal to the mass.
在针对肿瘤的肝活检中，区分肿瘤周围纤维化和慢性肝病引起的纤维化具有挑战性。我们评估了肿瘤周围纤维化从转移性结直肠腺癌向肝延伸的距离。
对 25 例病例的肿瘤周围和远处无病变肝三色染色进行数字图像分析。在每个肿瘤和无病变肝中，以同心圆间隔定量纤维化。
与远处肝相比，肿瘤周围肝的纤维化在最初 0.5 毫米处增加了 3.9 倍（范围 0.9-18.6）。纤维化水平在距离肿瘤中位数 2.5 毫米（四分位距 1.5-5.0 毫米）处恢复基线。
肿瘤周围肝的纤维化明显增加。在大约 75%的病例中，距离肿瘤 5 毫米处纤维化水平恢复基线。对于没有距离肿瘤至少 5 毫米的肝组织的针对肿瘤的肝活检，病理学家应谨慎对待纤维化。
