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The emerging family of hepatoblastoma tumours: from ontogenesis to
oncogenesis.Eur
J Cancer. 2005 Jul;41(11):1503-14.
The
identification of distinct types and subtypes of hepatoblastoma has
led to a successful classification of these lesions. In recent years,
and particularly within large tumour trials, the spectrum of
paediatric epithelial liver tumours has increased. This, together with
the need for defining clinically relevant risk groups, will require a
new approach to defining and classifying these cancers. Furthermore,
an impressive amount of molecular biological information on liver
ontogenesis and growth regulation of hepatic tumours has recently
accumulated, which will allow the development of a comprehensive
classification system with particular emphasis on prognostics. In this
review, novel findings relating to these issues are discussed.
Hepatoblastoma:
assessment of criteria for histologic classification.Med
Pediatr Oncol. 2002 Nov;39(5):478-83.
BACKGROUND:
Comparison of outcomes in different clinicopathologic studies of
hepatoblastoma requires reproducible histologic classification. This
review examines the diagnostic criteria employed by different
pathologists for the classification of subtypes of hepatoblastoma and
identifies specific problem areas. PROCEDURE: A selected review of
published literature is provided. RESULTS: Published studies
demonstrate that uniform criteria have not been applied in the
classification of hepatoblastoma. These discrepancies hinder attempts
to compare outcome data from different studies. Sampling error and
potential treatment effects further complicate analysis of the
published literature on the relationship between morphologic
classification and outcome. CONCLUSIONS: Standardized criteria are
essential to allow reproducible histologic classification of
hepatoblastoma. There is significant variation in diagnostic criteria
used to define the major subtypes of hepatoblastoma in published
studies. Additional potential problems are identified in sampling
methods and treatment effects.
Clinicopathological
and immunohistochemical study of hepatoblastoma.Hua
Xi Yi Ke Da Xue Xue Bao. 1998 Sep;29(3):298-301.
To investigate
the relationship between immunoreaction of histologic subtype and
prognosis, this paper analysed the clinicopathological data from 20
cases of hepatoblastoma. Immunohistochemical staining was performed in
18 cases. The results showed that cytopolasmic postivities of
epithlial tumor cells were observed by CK, AFP, S-100 protein and
vimentin in 14, 10, 9 and 4 cases respectively. Positive staining for
CEA was seen in the nuclei of epithelial tumor cells in 11 cases.
Nuclear P53 protein staining was found in 9 cases. Nuclear and
cytoplasmic postivities of P16 protein were observed in 7 cases. S-100
protein, vimentin, CK and P16 protein were detected in mesenchymal
component in 1 case. This study suggested that immunoreactions of
hepatoblastomas were different in histologic subtypes. The expression
may correlate with the neoplastic differentiation and prognosis.
Neuroendocrine
differentiation in hepatoblastoma. An immunohistochemical
investigation.Am
J Surg Pathol. 1990;14(9):847-55.
Hepatoblastoma
exhibits a wide range of epithelial and mesenchymal lines of
differentiation. Neuroendocrine differentiation in this tumor has not
previously been reported. We investigated seven hepatoblastomas of
different subtypes (five pure epithelial hepatoblastomas, including
one small-cell hepatoblastoma, and two mixed hepatoblastomas) using a
broad panel of antibodies against epithelial, mesenchymal, neural, and
neuroendocrine markers, alpha-1-antitrypsin (alpha 1-AT),
alpha-1-antichymotrypsin (alpha 1-ACT), alpha-fetoprotein (AFP),
carcinoembryonic antigen (CEA), serotonin, and 14 regulatory peptides.
Chromogranin A-immunoreactive neuroendocrine tumor cells, some of
which also exhibited immunoreactivity for serotonin and somatostatin,
were found in the fetal and embryonal parts of the mixed
hepatoblastomas. The osteoid-like material in the mixed
hepatoblastomas contained cells with immunoreactivity for chromogranin
A, neuron-specific enolase, keratin, and alpha 1-AT, alpha 1-ACT, AFP,
and CEA, in addition to S-100 protein and vimentin. Parallels to the
neuroendocrine differentiation in hepatoblastomas are found in tumors
of the gastrointestinal tract and bronchopulmonary tree. These tumors
may also exhibit a neuroendocrine component; that is, multidirectional
differentiation may occur, as in hepatoblastoma. The immunoreactivity
of some of the cells of the osteoid-like material for keratin, alpha
1-AT, alpha 1-ACT, AFP, CEA, and chromogranin A suggests that these
cells--and probably the surrounding material--are of epithelial
origin.
Hepatoblastoma: an immunohistochemical and ultrastructural study.Hum
Pathol. 1987 Oct;18(10):1025-35.
The
ultrastructural and immunohistochemical features of 19 hepatoblastomas
were examined to evaluate the phenotypic expressivity of this solid
embryonic neoplasm of childhood. Electron microscopy confirmed the
embryonal and fetal characteristics of the neoplastic hepatocytes, but
in addition, cells with features intermediate between these two cell
types were identified. Dense bundles of collagen corresponding to the
osteoid-like material by light microscopy surrounded nests of cells;
the cells within this matrix stained for epithelial membrane antigen
and vimentin and focally for cytokeratin, and they showed
ultrastructural features of epithelial cells. The two cases of small
cell hepatoblastoma reacted positively for vimentin and cytokeratin;
the remaining 17 cases were immunoreactive for cytokeratin and
alpha-fetoprotein, and some also for alpha 1-antitrypsin, ferritin,
and vimentin. A histogenetic scheme based on our findings is proposed
to explain the divergent morphologic features of this neoplasm.
Hepatoblastoma. Attempt at characterization of
histologic subtypes.
Am J Surg
Pathol. 1982 Oct;6(7):599-612.
This is a clinicopathologic study summarizing the
experience with hepatoblastomas at Children's Memorial Hospital of
Chicago between 1954 and 1981. Of 21 patients studied, 13 (61.9%)
died. Three major histologic epithelial patterns were identified:
fetal, embryonal, and macrotrabecular. The first two may represent
different stages of cytodifferentiation of hepatoblastoma cells. The
macrotrabecular type had features similar to hepatocellular carcinoma
of adults, from which distinction was difficult; this type pursued an
aggressive clinical course. The fetal type exhibited advanced
differentiation, and two cases in this category survived after surgery
only; local extrahepatic dissemination was present in other cases of
the fetal type. Mixed epithelial and mesenchymal tumors constituted
only 23% of this series, and none contained rhabdomyoblastic elements.
Although modern chemotherapy may alter the course of this disease, the
small size of this series precluded definite statements in this
regard. Only patients in whom the tumor was completely excised as
primary treatment became long-term survivors. |
