Hepatocellular Carcinomas with Granulomatous Inflammation In Tumor Stroma: Clinicopathologic Characteristics.

IF 1.1 Q4 PATHOLOGY Turkish Journal of Pathology Pub Date : 2022-01-01 DOI:10.5146/tjpath.2021.01562
Burcu Saka, Ferhat Ozden, Ayse Armutlu, Gokhan Ertugrul
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引用次数: 1

Abstract

Objective: To determine the frequency of granulomatous inflammation within hepatocellular carcinoma (HCC) and its clinicopathologic associations. Material and Method: Fifty-eight HCCs (51 explants, 3 lobectomies, and 4 segmentectomies) were reviewed. Results: Five (8.6%) cases (F/M=1/4, mean age: 63.6) were identified with granulomas.1/5 had history of neoadjuvant therapy. 4/5 patients presented with early stage (pT1/2). All were well-differentiated (Grade1-2/4). The mean number of tumor foci was 3.6, with a median size of 2.2 cm. All of them had advanced fibrosis. No difference was identified from cases without granulomas (n=53) in terms of prognosis and aforementioned parameters (p> 0.05). Granulomas were mainly concentrated in peripheral parts of the tumors. One case with nodule-in-nodule formation had granulomas lined along the border of the inner nodule. In 2 cases, granulomas were identified in steatohepatitic areas, while another had clear cell change. Only 1 had necrotizing granulomas, none with acid resistant bacilli. Two cases revealed concomitant granulomas in the adjacent liver parenchyma in addition to the tumor stroma. Except for one with a history of tuberculosis, none of the cases had a granulomatous disease. Conclusion: This is the largest case series of HCCs with granulomas by far. Our data revealed neither clinicopathologic and prognostic difference nor definite etiology related to granulomas. Yet, association with steatotic and clear tumor cells suggests the role of cytoplasmic content, while distribution of granulomas points to host immune response.

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肝细胞癌伴间质肉芽肿性炎症:临床病理特征。
目的:探讨肝细胞癌(HCC)肉芽肿性炎症的发生频率及其与临床病理的关系。材料和方法:回顾了58例hcc(51例外植体,3例肺叶切除术,4例节段切除术)。结果:确诊肉芽肿5例(8.6%),F/M=1/4,平均年龄63.6岁。1/5有新辅助治疗史。4/5患者表现为早期(pT1/2)。均为高分化(1-2/4级)。平均3.6个肿瘤灶,中位大小为2.2 cm。他们都患有晚期纤维化。与非肉芽肿患者(n=53)在预后及上述参数方面无差异(p > 0.05)。肉芽肿主要集中在肿瘤周围。1例结节内形成肉芽肿,肉芽肿沿内结节边缘排列。2例在脂肪性肝区发现肉芽肿,另1例有明显的细胞改变。仅有1例坏死性肉芽肿,无耐酸杆菌。除肿瘤间质外,2例相邻肝实质同时有肉芽肿。除1例有结核病史外,其余病例均无肉芽肿性疾病。结论:这是迄今为止最大的hcc合并肉芽肿病例系列。我们的资料既没有显示肉芽肿的临床病理和预后差异,也没有明确的病因。然而,与脂肪变性和透明肿瘤细胞的关联提示细胞质含量的作用,而肉芽肿的分布提示宿主免疫应答。
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来源期刊
CiteScore
1.90
自引率
10.00%
发文量
23
审稿时长
14 weeks
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