Primary Hepatic Malignant Fibrous Histiocytoma Mimicking Hepatocellular Carcinoma: Report of Two Cases with Immunohistochemical Detection of Ezrin, and Ultrastructural and K-ras Mutation Analysis

Phui Ly Liew, Ming Te Huang, Sey-En Lin, Hsin An Chen, Chih Hsiung Wu, Wei Hwa Lee

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2 Citations (Scopus)

Abstract

We reported two primary malignant fibrous histiocytoma (MFH) cases (cases 1 and 2) strikingly simulating hepatocellular carcinoma with immunohistochemical (IHC) stains, and ultrastructural and K-ras mutation analysis. Cases 1 and 2 both included only men, aged 65 and 72 years, respectively. Case 1 presented with abdominal pain, fever, and bilateral legs edema. Case 2 was found to have a liver tumor during routine heath examination. Computed tomography scan showed hepatic mass with fine tumor vessels. Case 1 had one 16×15×13cm 3 liver mass with tumor rupture in the right lobe, and case 2 had one 3×2.5×1cm 3 liver tumor in segment 6. Microscopically, the tumors were composed of spindle, pleomorphic, and multinucleated giant cells arranged in storiform, sheet-like, and fascicular patterns. Strong immunoreactivity for CD68 and vimentin in tumor cells in both cases was noticed. Ezrin immunoexpression in tumor tissue from case 1 was diffusely strong; in contrast, case 2 showed sparse and weak ezrin expression in tumor cells. Ultrastructurally, cells with fibroblasts and histiocytic characteristics were present in both cases. K-ras gene analysis of exon 2codon 12 or 13 showed no mutation. This is the first report describing K-ras gene analysis of liver MFH. We emphasize that ezrin immunoreactivity may be correlated with poorer prognosis.

Original languageEnglish
Pages (from-to)183-188
Number of pages6
JournalJournal of Experimental and Clinical Medicine(Taiwan)
Volume4
Issue number3
DOIs
Publication statusPublished - Jun 2012

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Malignant Fibrous Histiocytoma
Hepatocellular Carcinoma
Mutation
Liver
Neoplasms
ras Genes
ezrin
Vimentin
Giant Cells
Abdominal Pain
Rupture
Exons
Edema
Leg
Fever
Coloring Agents
Fibroblasts
Tomography

Keywords

  • Ezrin
  • K-ras mutation
  • Liver
  • Malignant fibrous histiocytoma
  • Ultrastructural

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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title = "Primary Hepatic Malignant Fibrous Histiocytoma Mimicking Hepatocellular Carcinoma: Report of Two Cases with Immunohistochemical Detection of Ezrin, and Ultrastructural and K-ras Mutation Analysis",
abstract = "We reported two primary malignant fibrous histiocytoma (MFH) cases (cases 1 and 2) strikingly simulating hepatocellular carcinoma with immunohistochemical (IHC) stains, and ultrastructural and K-ras mutation analysis. Cases 1 and 2 both included only men, aged 65 and 72 years, respectively. Case 1 presented with abdominal pain, fever, and bilateral legs edema. Case 2 was found to have a liver tumor during routine heath examination. Computed tomography scan showed hepatic mass with fine tumor vessels. Case 1 had one 16×15×13cm 3 liver mass with tumor rupture in the right lobe, and case 2 had one 3×2.5×1cm 3 liver tumor in segment 6. Microscopically, the tumors were composed of spindle, pleomorphic, and multinucleated giant cells arranged in storiform, sheet-like, and fascicular patterns. Strong immunoreactivity for CD68 and vimentin in tumor cells in both cases was noticed. Ezrin immunoexpression in tumor tissue from case 1 was diffusely strong; in contrast, case 2 showed sparse and weak ezrin expression in tumor cells. Ultrastructurally, cells with fibroblasts and histiocytic characteristics were present in both cases. K-ras gene analysis of exon 2codon 12 or 13 showed no mutation. This is the first report describing K-ras gene analysis of liver MFH. We emphasize that ezrin immunoreactivity may be correlated with poorer prognosis.",
keywords = "Ezrin, K-ras mutation, Liver, Malignant fibrous histiocytoma, Ultrastructural",
author = "Liew, {Phui Ly} and Huang, {Ming Te} and Sey-En Lin and Chen, {Hsin An} and Wu, {Chih Hsiung} and Lee, {Wei Hwa}",
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T2 - Report of Two Cases with Immunohistochemical Detection of Ezrin, and Ultrastructural and K-ras Mutation Analysis

AU - Liew, Phui Ly

AU - Huang, Ming Te

AU - Lin, Sey-En

AU - Chen, Hsin An

AU - Wu, Chih Hsiung

AU - Lee, Wei Hwa

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N2 - We reported two primary malignant fibrous histiocytoma (MFH) cases (cases 1 and 2) strikingly simulating hepatocellular carcinoma with immunohistochemical (IHC) stains, and ultrastructural and K-ras mutation analysis. Cases 1 and 2 both included only men, aged 65 and 72 years, respectively. Case 1 presented with abdominal pain, fever, and bilateral legs edema. Case 2 was found to have a liver tumor during routine heath examination. Computed tomography scan showed hepatic mass with fine tumor vessels. Case 1 had one 16×15×13cm 3 liver mass with tumor rupture in the right lobe, and case 2 had one 3×2.5×1cm 3 liver tumor in segment 6. Microscopically, the tumors were composed of spindle, pleomorphic, and multinucleated giant cells arranged in storiform, sheet-like, and fascicular patterns. Strong immunoreactivity for CD68 and vimentin in tumor cells in both cases was noticed. Ezrin immunoexpression in tumor tissue from case 1 was diffusely strong; in contrast, case 2 showed sparse and weak ezrin expression in tumor cells. Ultrastructurally, cells with fibroblasts and histiocytic characteristics were present in both cases. K-ras gene analysis of exon 2codon 12 or 13 showed no mutation. This is the first report describing K-ras gene analysis of liver MFH. We emphasize that ezrin immunoreactivity may be correlated with poorer prognosis.

AB - We reported two primary malignant fibrous histiocytoma (MFH) cases (cases 1 and 2) strikingly simulating hepatocellular carcinoma with immunohistochemical (IHC) stains, and ultrastructural and K-ras mutation analysis. Cases 1 and 2 both included only men, aged 65 and 72 years, respectively. Case 1 presented with abdominal pain, fever, and bilateral legs edema. Case 2 was found to have a liver tumor during routine heath examination. Computed tomography scan showed hepatic mass with fine tumor vessels. Case 1 had one 16×15×13cm 3 liver mass with tumor rupture in the right lobe, and case 2 had one 3×2.5×1cm 3 liver tumor in segment 6. Microscopically, the tumors were composed of spindle, pleomorphic, and multinucleated giant cells arranged in storiform, sheet-like, and fascicular patterns. Strong immunoreactivity for CD68 and vimentin in tumor cells in both cases was noticed. Ezrin immunoexpression in tumor tissue from case 1 was diffusely strong; in contrast, case 2 showed sparse and weak ezrin expression in tumor cells. Ultrastructurally, cells with fibroblasts and histiocytic characteristics were present in both cases. K-ras gene analysis of exon 2codon 12 or 13 showed no mutation. This is the first report describing K-ras gene analysis of liver MFH. We emphasize that ezrin immunoreactivity may be correlated with poorer prognosis.

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