Hepatocellular carcinoma metastatic to skin: diagnostic utility of antihuman hepatocyte antibody in combination with albumin in situ hybridization
Background: Cutaneous metastases from hepatic neoplasms are rare. Histologic features of hepatocellular carcinoma (HCC) are often poorly differentiated, hindering accurate diagnosis on routine examination by hematoxylin‐eosin stain. Antihuman hepatocyte antibody is highly sensitive for HCC but can...
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Published in | Journal of cutaneous pathology Vol. 36; no. 2; pp. 262 - 266 |
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Main Authors | , , |
Format | Journal Article |
Language | English |
Published |
Oxford, UK
Blackwell Publishing Ltd
01.02.2009
Wiley-Blackwell |
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Abstract | Background: Cutaneous metastases from hepatic neoplasms are rare. Histologic features of hepatocellular carcinoma (HCC) are often poorly differentiated, hindering accurate diagnosis on routine examination by hematoxylin‐eosin stain. Antihuman hepatocyte antibody is highly sensitive for HCC but can be strongly expressed in other adenocarcinomas. Albumin in situ hybridization (ISH) is highly specific and sensitive for HCC; in combination with antihuman hepatocyte antibody, it has a diagnostic sensitivity approaching 100%. To our knowledge, the combination of antihuman hepatocyte antibody and albumin ISH has not previously been examined in the context of cutaneous HCC.
Methods: We present histologic findings and results of ancillary studies for three patients with metastatic HCC. These patients had a poorly differentiated cytokeratin‐positive cutaneous neoplasm. All three cases were evaluated with antihuman hepatocyte antibody and albumin ISH.
Results: Neoplastic cells were strongly positive for antihuman hepatocyte antibody, and ISH detected albumin messenger RNA in nearly 100% of the neoplastic cells in all three cases.
Conclusions: The combination of antihuman hepatocyte antibody and albumin ISH is highly sensitive and specific for HCC metastatic to skin and is useful in the differential diagnosis of a poorly differentiated cytokeratin‐positive neoplasm. |
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AbstractList | Cutaneous metastases from hepatic neoplasms are rare. Histologic features of hepatocellular carcinoma (HCC) are often poorly differentiated, hindering accurate diagnosis on routine examination by hematoxylin-eosin stain. Antihuman hepatocyte antibody is highly sensitive for HCC but can be strongly expressed in other adenocarcinomas. Albumin in situ hybridization (ISH) is highly specific and sensitive for HCC; in combination with antihuman hepatocyte antibody, it has a diagnostic sensitivity approaching 100%. To our knowledge, the combination of antihuman hepatocyte antibody and albumin ISH has not previously been examined in the context of cutaneous HCC.
We present histologic findings and results of ancillary studies for three patients with metastatic HCC. These patients had a poorly differentiated cytokeratin-positive cutaneous neoplasm. All three cases were evaluated with antihuman hepatocyte antibody and albumin ISH.
Neoplastic cells were strongly positive for antihuman hepatocyte antibody, and ISH detected albumin messenger RNA in nearly 100% of the neoplastic cells in all three cases.
The combination of antihuman hepatocyte antibody and albumin ISH is highly sensitive and specific for HCC metastatic to skin and is useful in the differential diagnosis of a poorly differentiated cytokeratin-positive neoplasm. Background:Cutaneous metastases from hepatic neoplasms are rare. Histologic features of hepatocellular carcinoma (HCC) are often poorly differentiated, hindering accurate diagnosis on routine examination by hematoxylin-eosin stain. Antihuman hepatocyte antibody is highly sensitive for HCC but can be strongly expressed in other adenocarcinomas. Albumin in situ hybridization (ISH) is highly specific and sensitive for HCC; in combination with antihuman hepatocyte antibody, it has a diagnostic sensitivity approaching 100%. To our knowledge, the combination of antihuman hepatocyte antibody and albumin ISH has not previously been examined in the context of cutaneous HCC.Methods:We present histologic findings and results of ancillary studies for three patients with metastatic HCC. These patients had a poorly differentiated cytokeratin-positive cutaneous neoplasm. All three cases were evaluated with antihuman hepatocyte antibody and albumin ISH.Results:Neoplastic cells were strongly positive for antihuman hepatocyte antibody, and ISH detected albumin messenger RNA in nearly 100% of the neoplastic cells in all three cases.Conclusions:The combination of antihuman hepatocyte antibody and albumin ISH is highly sensitive and specific for HCC metastatic to skin and is useful in the differential diagnosis of a poorly differentiated cytokeratin-positive neoplasm.Wood AJ, Lappinga PJ, Ahmed I. Hepatocellular carcinoma metastatic to skin: diagnostic utility of antihuman hepatocyte antibody in combination with albumin in situ hybridization. J Cutan Pathol 2009; 36: 262-266. [copy 2008 Blackwell Munksgaard. Background: Cutaneous metastases from hepatic neoplasms are rare. Histologic features of hepatocellular carcinoma (HCC) are often poorly differentiated, hindering accurate diagnosis on routine examination by hematoxylin‐eosin stain. Antihuman hepatocyte antibody is highly sensitive for HCC but can be strongly expressed in other adenocarcinomas. Albumin in situ hybridization (ISH) is highly specific and sensitive for HCC; in combination with antihuman hepatocyte antibody, it has a diagnostic sensitivity approaching 100%. To our knowledge, the combination of antihuman hepatocyte antibody and albumin ISH has not previously been examined in the context of cutaneous HCC. Methods: We present histologic findings and results of ancillary studies for three patients with metastatic HCC. These patients had a poorly differentiated cytokeratin‐positive cutaneous neoplasm. All three cases were evaluated with antihuman hepatocyte antibody and albumin ISH. Results: Neoplastic cells were strongly positive for antihuman hepatocyte antibody, and ISH detected albumin messenger RNA in nearly 100% of the neoplastic cells in all three cases. Conclusions: The combination of antihuman hepatocyte antibody and albumin ISH is highly sensitive and specific for HCC metastatic to skin and is useful in the differential diagnosis of a poorly differentiated cytokeratin‐positive neoplasm. BACKGROUNDCutaneous metastases from hepatic neoplasms are rare. Histologic features of hepatocellular carcinoma (HCC) are often poorly differentiated, hindering accurate diagnosis on routine examination by hematoxylin-eosin stain. Antihuman hepatocyte antibody is highly sensitive for HCC but can be strongly expressed in other adenocarcinomas. Albumin in situ hybridization (ISH) is highly specific and sensitive for HCC; in combination with antihuman hepatocyte antibody, it has a diagnostic sensitivity approaching 100%. To our knowledge, the combination of antihuman hepatocyte antibody and albumin ISH has not previously been examined in the context of cutaneous HCC.METHODSWe present histologic findings and results of ancillary studies for three patients with metastatic HCC. These patients had a poorly differentiated cytokeratin-positive cutaneous neoplasm. All three cases were evaluated with antihuman hepatocyte antibody and albumin ISH.RESULTSNeoplastic cells were strongly positive for antihuman hepatocyte antibody, and ISH detected albumin messenger RNA in nearly 100% of the neoplastic cells in all three cases.CONCLUSIONSThe combination of antihuman hepatocyte antibody and albumin ISH is highly sensitive and specific for HCC metastatic to skin and is useful in the differential diagnosis of a poorly differentiated cytokeratin-positive neoplasm. Background: Cutaneous metastases from hepatic neoplasms are rare. Histologic features of hepatocellular carcinoma (HCC) are often poorly differentiated, hindering accurate diagnosis on routine examination by hematoxylin‐eosin stain. Antihuman hepatocyte antibody is highly sensitive for HCC but can be strongly expressed in other adenocarcinomas. Albumin in situ hybridization (ISH) is highly specific and sensitive for HCC; in combination with antihuman hepatocyte antibody, it has a diagnostic sensitivity approaching 100%. To our knowledge, the combination of antihuman hepatocyte antibody and albumin ISH has not previously been examined in the context of cutaneous HCC. Methods: We present histologic findings and results of ancillary studies for three patients with metastatic HCC. These patients had a poorly differentiated cytokeratin‐positive cutaneous neoplasm. All three cases were evaluated with antihuman hepatocyte antibody and albumin ISH. Results: Neoplastic cells were strongly positive for antihuman hepatocyte antibody, and ISH detected albumin messenger RNA in nearly 100% of the neoplastic cells in all three cases. Conclusions: The combination of antihuman hepatocyte antibody and albumin ISH is highly sensitive and specific for HCC metastatic to skin and is useful in the differential diagnosis of a poorly differentiated cytokeratin‐positive neoplasm. |
Author | Ahmed, Iftikhar Lappinga, Paul J. Wood, Angela J. |
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Keywords | Drug combination Antibody Dermatology In situ Albumin Hepatic disease Hepatocellular carcinoma Malignant tumor Hybridization Metastasis Anatomic pathology Hepatocyte Digestive diseases Metastatic Skin Diagnosis Cancer |
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References | 2004; 122 2003; 119 1997; 44 1997; 21 2006; 35 2004; 25 1999; 24 2007; 51 2007; 52 2003; 30 2001; 40 2007; 14 2001; 64 2007; 27 e_1_2_5_14_2 e_1_2_5_13_2 e_1_2_5_9_2 Okusaka T (e_1_2_5_8_2) 1997; 44 Al‐Mashat FM (e_1_2_5_12_2) 2004; 25 e_1_2_5_7_2 e_1_2_5_10_2 e_1_2_5_6_2 e_1_2_5_5_2 e_1_2_5_4_2 e_1_2_5_11_2 e_1_2_5_2_2 Nggada HA (e_1_2_5_15_2) 2006; 35 Fang YR (e_1_2_5_3_2) 2001; 64 |
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Snippet | Background: Cutaneous metastases from hepatic neoplasms are rare. Histologic features of hepatocellular carcinoma (HCC) are often poorly differentiated,... Cutaneous metastases from hepatic neoplasms are rare. Histologic features of hepatocellular carcinoma (HCC) are often poorly differentiated, hindering accurate... Background: Cutaneous metastases from hepatic neoplasms are rare. Histologic features of hepatocellular carcinoma (HCC) are often poorly differentiated,... Background:Cutaneous metastases from hepatic neoplasms are rare. Histologic features of hepatocellular carcinoma (HCC) are often poorly differentiated,... BACKGROUNDCutaneous metastases from hepatic neoplasms are rare. Histologic features of hepatocellular carcinoma (HCC) are often poorly differentiated,... |
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SubjectTerms | Aged Albumins - biosynthesis Albumins - immunology Antibodies, Neoplasm - chemistry Antibodies, Neoplasm - immunology Biological and medical sciences Carcinoma, Hepatocellular - immunology Carcinoma, Hepatocellular - metabolism Carcinoma, Hepatocellular - pathology Dermatology Diagnosis, Differential Female Gastroenterology. Liver. Pancreas. Abdomen Hepatocytes - immunology Hepatocytes - metabolism Humans In Situ Hybridization - methods Liver. Biliary tract. Portal circulation. Exocrine pancreas Male Medical sciences Middle Aged Neoplasm Metastasis Neoplasm Proteins - biosynthesis Neoplasm Proteins - immunology RNA, Messenger - biosynthesis RNA, Neoplasm - biosynthesis Skin Neoplasms - immunology Skin Neoplasms - metabolism Skin Neoplasms - pathology Skin Neoplasms - secondary Tumors |
Title | Hepatocellular carcinoma metastatic to skin: diagnostic utility of antihuman hepatocyte antibody in combination with albumin in situ hybridization |
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