Pigmented hepatocellular adenoma with complete CD34 immunostaining pattern: a diagnostic dilemma
Mukul Vij1, Sushma Patra, Mohamed Rela
1Department of Pathology, Global Hospital and Health City, Chennai, Tamil Nadu, India.
Indian Journal of Pathology & Microbiology
|March 5, 2013
Summary
This study reports a rare case of pigmented hepatocellular adenoma in a woman, characterized by Dubin Johnson-like pigment and a complete CD34 staining pattern. This finding adds to the limited literature on this specific liver tumor subtype.
Area of Science:
- Hepatobiliary pathology
- Gastroenterology
- Surgical oncology
Background:
- Hepatocellular adenoma (HCA) is a benign liver tumor, more prevalent in women.
- WHO classification defines HCA by hepatocyte-like cells in plates separated by sinusoids.
- Pigmented HCA is an exceptionally rare subtype.
Observation:
- A 41-year-old female presented with a 10x8 cm liver mass detected during dyspepsia evaluation.
- Imaging revealed a significant liver lesion, leading to extended left hepatectomy.
- Gross examination showed a circumscribed, dark gray to black liver tumor.
Findings:
- Microscopic analysis confirmed hepatocellular adenoma with abundant Dubin Johnson-like pigment.
- CD34 immunostaining demonstrated a complete sinusoidal pattern.
- The tumor was classified as pigmented hepatic adenoma with a complete CD34 staining pattern.
Implications:
- This case contributes to the scarce world literature on pigmented hepatocellular adenoma, with only eight previously described instances.
- Understanding the unique histological and staining characteristics of pigmented HCA is crucial for accurate diagnosis.
- Further research may elucidate the specific mechanisms and clinical significance of pigment deposition in HCA.
