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Lung tumor

Adenocarcinoma

Hepatoid adenocarcinoma


Reviewer: Deepali Jain, M.D. (see Reviewers page)
Revised:11 January 2013, last major update September 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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● Resembles hepatocellular carcinoma (HCC)
● More common in gastric than pulmonary adenocarcinoma
● Usually older men (range, 35-82 years)
● High serum AFP
● Aggressive behavior, often with liver metastases

Case reports
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● 36 year old man with AFP producing tumor (Am J Surg Pathol 1997;21:1113)
● 55 year old man with smoking history (Lung Cancer 2002;38:211)

Gross images
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5 cm tumor with firm-white and necrotic parts

Micro description
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● Liver metastases resemble HCC

Micro images
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Papillary or trabecular pattern of HCC-like cells (A/B), with hyaline globules (C) and AFP+ cells (D)


Various images

Immunohistochemistry
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● Same as HCC: AFP+, CK8/CK18+, canalicular staining with polyclonal CEA (Am J Surg Pathol 2003;27:1302)
● Different from HCC: CK19+, CK20+ (HCC is rarely CK20+ Eur J Histochem 2009;53:e32) , negative for HepPar1, negative for CK7

Molecular description
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● 4q-, 8p-, Xq+ (seen in HCC and hepatoblastoma)

Differential diagnosis
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● Metastatic hepatocellular carcinoma, metastatic hepatoid adenocarcinoma from stomach, gallbladder or other site

End of Lung tumor > Adenocarcinoma > Hepatoid adenocarcinomal


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