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Liver and intrahepatic bile ducts - tumor

Hepatocellular carcinoma

Sarcomatoid variant of hepatocellular carcinoma


Reviewers: Deepali Jain, M.D. (see Reviewers page)
Revised: 9 January 2013, last major update February 2012
Copyright: (c) 2004-2013, PathologyOutlines.com, Inc.

General
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● Also called spindle cell hepatocellular carcinoma, pseudosarcomatous
● Diffuse collection of spindle cells resembling fibrosarcoma or malignant fibrous histiocytoma, but with classic hepatocellular carcinoma is also present
● Note: 1-9% of all hepatocellular carcinomas have prominent sarcomatoid pattern

Clinical features
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● Mean age 62 years old, range 46-84 years, usually men
● Metastases common, often to lung and lymph nodes
● Most patients die of disease

Gross images
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Various images

Micro description
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● Diffuse collection of spindle cells resembling fibrosarcoma or malignant fibrous histiocytoma
● Classic hepatocellular carcinoma is also present
● May have pleomorphic and osteoclast-like giant cells, chondroid differentiation (Pathol Int 2000;50:919)

Micro images
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Various images

Positive stains
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● Cytokeratin (60%), alpha fetoprotein
● Variable HHF35, smooth muscle actin, desmin, CD68 and S100

Differential diagnosis
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● Collision tumor
● Carcinoma with foci of spindle shaped epithelial cells

End of Liver and intrahepatic bile ducts - tumor > Hepatocellular carcinoma > Sarcomatoid variant of hepatocellular carcinoma


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