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Review

Post-transplant liver biopsies: a concise and practical approach for beginners: Mohamad Besher Ourfali, David Hirsch, Marianna Scranton, Tony El Jabbour; J Pathol Transl Med. 2025;59(1):1-10. Published online January 15, 2025; DOI: https://doi.org/10.4132/jptm.2024.11.15

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Abstract PDF

Exposure to post-transplant liver biopsies varies among pathology residencies and largely depends on the institution's training program, particularly if the hospital has a liver transplant program. The interpretation of biopsies from transplanted livers presents its own set of challenges, even for those with a solid understanding of non-transplant medical liver biopsies. In this review, we aim to provide a succinct, step-by-step approach to help you interpret liver transplant biopsies. This article may be beneficial for residents interested in liver pathology, gastrointestinal and liver pathology fellows in the early stages of training, clinical gastroenterology and hepatology fellows, hepatologists and general pathologists who are curious about this niche.

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Histological and Molecular Evaluation of Liver Biopsies: A Practical and Updated Review
Joon Hyuk Choi
International Journal of Molecular Sciences.2025; 26(16): 7729. CrossRef

Case Study

Hepatic small vessel neoplasm: not totally benign, not yet malignant: Madison Miranda, David Howell, Tony El Jabbour; J Pathol Transl Med. 2023;57(5):273-277. Published online August 24, 2023; DOI: https://doi.org/10.4132/jptm.2023.06.19

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Abstract PDF

Hepatic small vessel neoplasm (HSVN) is a rare vascular tumor with few reports in the literature. While imaging findings may show characteristic enhancement patterns, limited available literature may not reveal the full potential for image-based diagnosis. Histologically, HSVN mimics other entities, though certain morphologic and immunohistochemical findings provide clues for diagnosis. However, HSVN still provides diagnostic challenges, especially on core biopsies with limited material for morphologic and molecular evaluation. While current recommendations are surgical resection and close observation, the long-term course of the tumor is unknown. We report a case of HSVN in a liver with additional feature of organized lymphoid aggregates necessitating additional hematopathology consultation and workup to rule out concurrent entities.

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Mesenchymal Tumors of the Liver: An Update Review
Joon Hyuk Choi, Swan N. Thung
Biomedicines.2025; 13(2): 479. CrossRef
Revisiting Hepatic Small Vessel Neoplasms and Anastomosing Hemangiomas as a Unique Capillary Liver Neoplasm: A 25-Case Series With Pathomolecular Correlations
Aurélie Beaufrère, Astrid Laurent-Bellue, Antoinette Lemoine, Agnès Bourillon, Nathalie Sturm, Pierre Gosset, Virginie Cahn, Valérie Vilgrain, Maité Lewin, Valérie Paradis, Catherine Guettier
Modern Pathology.2025; 38(10): 100835. CrossRef
Imaging features of recently identified low-grade vascular neoplasia of the liver: hepatic small vessel neoplasm and anastomosing hemangioma
Maïté Lewin, Rauda Aldhaheri, Aurélie Beaufrère, Christophe Desterke, Anita Paisant, Ivan Bricault, Paul Borde, Gabriel Simon, Mickaël Lesurtel, Daniel Cherqui, Clara Prud’Homme, Valérie Vilgrain, Astrid Laurent-Bellue
European Radiology.2025;[Epub] CrossRef

Review

A review of liver fibrosis and cirrhosis regression: Michael J. Lee; J Pathol Transl Med. 2023;57(4):189-195. Published online June 20, 2023; DOI: https://doi.org/10.4132/jptm.2023.05.24

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Abstract PDF

Cirrhosis has traditionally been considered an irreversible process of end-stage liver disease. With new treatments for chronic liver disease, there is regression of fibrosis and cirrhosis, improvement in clinical parameters (i.e. liver function and hemodynamic markers, hepatic venous pressure gradient), and survival rates, demonstrating that fibrosis and fibrolysis are a dynamic process moving in two directions. Microscopically, hepatocytes push into thinning fibrous septa with eventual perforation leaving behind delicate periportal spikes in the portal tracts and loss of portal veins. Obliterated portal veins during progressive fibrosis and cirrhosis due to parenchymal extinction, vascular remodeling and thrombosis often leave behind a bile duct and hepatic artery within the portal tract. Traditional staging classification systems focused on a linear, progressive process; however, the Beijing classification system incorporates both the bidirectional nature for the progression and regression of fibrosis. However, even with regression, vascular lesions/remodeling, parenchymal extinction and a cumulative mutational burden place patients at an increased risk for developing hepatocellular carcinoma and should continue to undergo active clinical surveillance. It is more appropriate to consider cirrhosis as another stage in the evolution of chronic liver disease as a bidirectional process rather than an end-stage, irreversible state.

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Molecular and cellular secrets revealed: How umbilical cord-derived mesenchymal stem cells can target hepatocellular carcinoma
Mohammad Sadegh Izadi, Reza Arefnezhad, Amirmasoud Asadi, Aryan Rezaee, Leila Kalantari, Farzad Nasrpour Tahouneh, Mohammad Mehdi Shadravan, Seyyed Taher Seyyed Mahmoudi, Zahra GhaniBeygi, Fatemeh Rostamnezhad, Armin Razman, Fardad Ejtehadi, Fatemeh Rezae
Tissue and Cell.2026; 98: 103200. CrossRef
Diagnostic Utility of Apparent Diffusion Coefficient Values of Spleen and Liver in Assessment of Severity of Portal Hypertension and Liver Cirrhosis
Kommuri Siddhardha, S. Jalaludheen, Senthil Kumar Aiyappan
Nigerian Postgraduate Medical Journal.2026; 33(1): 118. CrossRef
Head to head: should portal inflammation be part of grading necroinflammatory activity in metabolic dysfunction‐associated steatotic liver disease?
Daniela Allende, Alastair D Burt
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Mohammadreza Elhaie, Abolfazl Koozari, Iraj Abedi
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Physical Activity and Liver Fibrosis: A Stratified Analysis by Obesity and Diabetes Status
Junghwan Cho, Sunghwan Suh, Ji Min Han, Hye In Kim, Hanaro Park, Hye Rang Bak, Ji Cheol Bae
Journal of Clinical Medicine.2026; 15(2): 757. CrossRef
Serum Kallistatin level as a biomarker for evaluation of liver function status in cirrhotic patients
Mahmoud Rizk, F. M. Khalil, Mohamed El-Assal, Hussien Ali, Ahmed R. Mohamed, Samer S. Zekry, Abeer Mahmoud El-Bahy, Amira Kamal ElDin Mohammed ElAlfy
Egyptian Liver Journal.2026;[Epub] CrossRef
The Dual-Faceted Role of Metal-Based Nanomaterials in Hepatic Fibrosis Therapy
Yinqing Mao, Yankai Gong, Xue Bai
International Journal of Nanomedicine.2026; Volume 21: 1. CrossRef
Reply to the Letter on “Clinical implications of fibrosis marker dynamics after hepatitis C cure: insights from paired biopsies”
Hung-Wei Wang, Cheng-Yuan Peng
Journal of the Formosan Medical Association.2026;[Epub] CrossRef
Low-Grade Chronic Inflammation: a Shared Mechanism for Chronic Diseases
Mariana Cifuentes, Hugo E. Verdejo, Pablo F. Castro, Alejandro H. Corvalan, Catterina Ferreccio, Andrew F. G. Quest, Marcelo J. Kogan, Sergio Lavandero
Physiology.2025; 40(1): 4. CrossRef
Natural History of Metabolic Dysfunction-Associated Steatotic Liver Disease: From Metabolic Syndrome to Hepatocellular Carcinoma
Melchor Alpízar Salazar, Samantha Estefanía Olguín Reyes, Andrea Medina Estévez, Julieta Alejandra Saturno Lobos, Jesús Manuel De Aldecoa Castillo, Juan Carlos Carrera Aguas, Samary Alaniz Monreal, José Antonio Navarro Rodríguez, Dulce María Fernanda Alpí
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Unveiling the Link between Albumin-Bilirubin Grade and Liver Fibrosis in Patients with a History of Gallstone and Gallbladder Surgery: A Focus on Metabolic Dysfunction-Associated Steatohepatitis
Mohammadjavad Sotoudeheian
The Korean Journal of Pancreas and Biliary Tract.2025; 30(1): 10. CrossRef
Impact of Weight Loss on Metabolic Dysfunction Associated Steatohepatitis and Hepatic Fibrosis
Marina W. Takawy, Manal F. Abdelmalek
Current Diabetes Reports.2025;[Epub] CrossRef
Nanoparticle-based therapeutic strategies for chronic liver diseases: Advances and insights
Sathiyamoorthy Padmanaban, Ji-Won Baek, Sai Sahithya Chamarthy, Saipriya Chandrasekaran, Antony V Samrot, Vijayakumar Gosu, In-Kyu Park, Kamalakannan Radhakrishnan, Don-Kyu Kim
Liver Research.2025; 9(2): 104. CrossRef
Innovative Strategies in the Diagnosis and Treatment of Liver Cirrhosis and Associated Syndromes
Ashok Kumar Sah, Mohd Afzal, Rabab H. Elshaikh, Anass M. Abbas, Manar G. Shalabi, Pranav Kumar Prabhakar, Asaad M. A. Babker, Fariza Tursunbaevna Khalimova, Velilyaeva Aliya Sabrievna, Ranjay Kumar Choudhary
Life.2025; 15(5): 779. CrossRef
Poly(I:C)-Stimulated Exosomes Mitigate Cholesterol-Induced Hepatic Fibrosis by Modulating the TGF-β/Smad3 Signal Transduction Pathway
Shahla Asadizadeh, Parichehreh Yaghmaei, Nasim Hayati Roodbari, Azam Khedri
Hepatitis Monthly.2025;[Epub] CrossRef
The postbiotic ReFerm® versus standard nutritional support in advanced alcohol-related liver disease (GALA-POSTBIO): a randomized controlled phase 2 trial
Johanne K. Hansen, Mads Israelsen, Suguru Nishijima, Sara E. Stinson, Peter Andersen, Stine Johansen, Camilla D. Hansen, Maximilian Joseph Brol, Sabine Klein, Robert Schierwagen, Frank Erhard Uschner, Karolina Sulek, Ida F. Villesen, Katrine P. Lindvig, K
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ADVANCING CURCUMIN APPLICATIONS IN HEPATOCELLULAR CARCINOMA: INSIGHTS INTO PHARMACOKINETICS, PHARMACODYNAMICS AND NANODELIVERY SYSTEMS
RESHMA T. MATE, ANURADHA N. CHIVATE, NAMDEO R. JADHAV, NIRANJAN D. CHIVATE
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Genetic Determinants of Apoptosis Regulate Liver Cirrhosis Risk: The FAS/FASL Polymorphism Connection in Iraqi Population
Wisam Hindawi Hoidy, Ahmed Ghdhban Al-Ziaydi
Indian Journal of Clinical Biochemistry.2025;[Epub] CrossRef
Histological and Molecular Evaluation of Liver Biopsies: A Practical and Updated Review
Joon Hyuk Choi
International Journal of Molecular Sciences.2025; 26(16): 7729. CrossRef
Resolving fibrosis by stimulating HSC-dependent extracellular matrix degradation
Sachin Sharma, Vijaya Prathigudupu, Carson Cable, Lia R. Serrano, Srilaxmi Nerella, Alina Chen, Ghmkin Hassan, Johnathon Lakins, Carlos Lizama Valenzuela, Tatsuya Tsukui, Roopa Ramamoorthi, Jae-Jun Kim, Holger Willenbring, Aras N. Mattis, Regan F. Volk, B
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Association of ANGPT2 and NOS3 Gene Variants With Esophageal Variceal Progression in HCV‐Induced Cirrhosis
Omnia S. Nabih, Mohamed Abdel‐Samiee, Marwa A. Tahoon, Elaf Abozeid, Heba Demerdash, Fatma Omar Khalil, Randa M. Seddik, Marwa L. Helal, Gamalat A. El Gedawy, HalaA E. Khalil, Badawy W AboBakr. Yossef, Ahmed B. Zaid, Mai I. Elashmawy
Journal of Medical Virology.2025;[Epub] CrossRef
Emerging advanced approaches for diagnosis and inhibition of liver fibrogenesis
Tamer A. Addissouky, Majeed M. A. Ali, Ibrahim El Tantawy El Sayed, Yuliang Wang
The Egyptian Journal of Internal Medicine.2024;[Epub] CrossRef
Inhibition of hepatic stellate cell activation by nutraceuticals: an emphasis on mechanisms of action
Vasudevan Sekar, Venkateish VP, Vani Vijay, Annapoorna BR, Nivya Vijayan, Madan Kumar Perumal
Journal of Food Science and Technology.2024; 61(11): 2046. CrossRef
The Role of Macrophage Inhibitory Factor in TAA-Induced Liver Fibrosis in Mice: Modulatory Effects of Betaine
Tatjana Radosavljevic, Dusan Vukicevic, Jasmina Djuretić, Kristina Gopcevic, Milica Labudovic Borovic, Sanja Stankovic, Janko Samardzic, Milica Radosavljevic, Danijela Vucevic, Vladimir Jakovljevic
Biomedicines.2024; 12(6): 1337. CrossRef
Fibrosis and Hepatocarcinogenesis: Role of Gene-Environment Interactions in Liver Disease Progression
Anindita Banerjee, Patrizia Farci
International Journal of Molecular Sciences.2024; 25(16): 8641. CrossRef
Multiomic predictors for regression of cirrhosis: Clinical implications and future directions
Binghua Li, Decai Yu
iLIVER.2024; 3(4): 100116. CrossRef
Commonly encountered symptoms and their management in patients with cirrhosis
Cyriac Abby Philips
Frontiers in Medicine.2024;[Epub] CrossRef
Antioxidant Potential of Xanthohumol in Disease Prevention: Evidence from Human and Animal Studies
Jakub Piekara, Dorota Piasecka-Kwiatkowska
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AdhMMP8 Vector Administration in Muscle: An Alternate Strategy to Regress Hepatic Fibrosis
Jesús García-Bañuelos, Edén Oceguera-Contreras, Ana Sandoval-Rodríguez, Blanca Estela Bastidas-Ramírez, Silvia Lucano-Landeros, Daniela Gordillo-Bastidas, Belinda C. Gómez-Meda, Arturo Santos, Eira Cerda-Reyes, Juan Armendariz-Borunda
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Nutritional deficiency in patients with liver cirrhosis
Maria S. Zhigalova, Vladimir V. Kiselev, Alla A. Ryk, Petr A. Yartsev
Clinical nutrition and metabolism.2023; 4(4): 265. CrossRef

Case Studies

Hepatic carcinoma expressing inhibin: case report of a proposed novel entity and review of the literature: Antonia Syrnioti, Evangelia Athanasiou, Prodromos Hytiroglou; J Pathol Transl Med. 2022;56(4):225-230. Published online June 15, 2022; DOI: https://doi.org/10.4132/jptm.2022.04.07

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Abstract PDF

Hepatic carcinoma expressing inhibin is a recently described neoplasm with varied architecture, including trabecular, pseudoglandular, follicular/microcystic, organoid, solid and tubular patterns of growth. We report a case of hepatic carcinoma expressing inhibin that occurred in a 47-year-old woman presenting with epigastric and back pain. The tumor was located in the left hepatic lobe and measured 12 cm in diameter. On immunohistochemical stains, the neoplastic cells were positive for inhibin, as well as cytokeratins 7, 8/18 and 19. There was mild focal expression of synaptophysin, and lack of expression of hepatocytic markers. The histogenesis of hepatic carcinoma expressing inhibin is presently uncertain. From a practical point of view, this neoplasm can potentially cause diagnostic pitfalls by simulating other primary or metastatic tumors, such as hepatocellular carcinoma, cholangiocarcinoma, neuroendocrine tumors, and follicular carcinoma of thyroid gland. Performing inhibin immunostain could assist in the differential diagnosis of liver tumors with unusual histologic features.

Citations

Citations to this article as recorded by

Cytologic Findings of Cholangioblastic Variant of Intrahepatic Cholangiocarcinoma: A Rare Variant and Cytologic Pitfall
Eleonora Fiorletta Quiroga, Maria Luisa C. Policarpio‐Nicolas
Diagnostic Cytopathology.2026; 54(1): 43. CrossRef
Cholangioblastic Cholangiocarcinoma (NIPBL::NACC1 Cholangiocarcinoma)
Pedram Argani, Kiyoko Oshima, Robert A. Anders, Raul S. Gonzalez, Osman Yilmaz, Munita Bal, Lisa Rooper, Jessica Hicks, Angelo De Marzo, Jeffrey Gagan, Chengsong Zhu, Doreen N. Palsgrove
American Journal of Surgical Pathology.2025; 49(4): 303. CrossRef
Primary Peritoneal Hepatoid Adenocarcinoma: A Multidisciplinary Approach for a Rare Case Scenario
Mahmoud A. Elseadany, Fatmaelzahraa Abdelfattah Denewar, Reham Mohamed Nagib, Raghda Tarek
Indian Journal of Gynecologic Oncology.2025;[Epub] CrossRef

Primary hepatic mixed germ cell tumor in an adult: Hyun-Jung Sung, Jihun Kim, Kyu-rae Kim, Shinkyo Yoon, Jae Hoon Lee, Hyo Jeong Kang; J Pathol Transl Med. 2021;55(5):355-359. Published online August 3, 2021; DOI: https://doi.org/10.4132/jptm.2021.06.16

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Abstract PDF

Primary hepatic mixed germ cell tumor (GCT) is very rare, and less than 10 cases have been reported. We report a case of mixed GCT composed of a choriocarcinoma and yolk sac tumor, which occurred in the liver of a 40-year-old woman. A large mass was detected by computed tomography solely in the liver. Serum β-human chorionic gonadotropin (hCG) was highly elevated, otherwise, other serum tumor markers were slightly elevated or within normal limits. For hepatic choriocarcinoma, neoadjuvant chemotherapy was administered, followed by right lobectomy. Histologic features of the resected tumor revealed characteristic choriocarcinoma features with diffuse positivity for hCG in the syncytiotrophoblasts and diffuse positivity for α-fetoprotein and Sal-like protein 4 in the yolk sac tumor components. Primary malignant GCT in the liver is associated with a poor prognosis and requires specific treatment. Therefore, GCT should be considered during a differential diagnosis of a rapidly growing mass in the liver.

Citations

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Mesenchymal Tumors of the Liver: An Update Review
Joon Hyuk Choi, Swan N. Thung
Biomedicines.2025; 13(2): 479. CrossRef
Testicular Seminoma in Prostate: Case Report and Review of Literature
Peter Lesko, Jana Obertova, Karol Kajo, Katarina Rejlekova, Zuzana Orszaghova, Viera Lehotska, Martina Ondrusova, Michal Chovanec, Dalibor Ondrus, Michal Mego
Clinical Genitourinary Cancer.2024; 22(2): 210. CrossRef

Primary hepatic extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue: Soyeon Choi, Ji Hye Kim, Kyungbin Kim, Misung Kim, Hye Jeong Choi, Young Min Kim, Jae Hee Suh, Min Jung Seo, Hee Jeong Cha; J Pathol Transl Med. 2020;54(4):340-345. Published online April 15, 2020; DOI: https://doi.org/10.4132/jptm.2020.03.18

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Abstract PDF

Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma), is one of the specific type of low-grade B-cell lymphoma not infrequently found worldwide. It typically involves mucosal sites such as stomach and conjunctiva; however, primary hepatic MALT lymphoma has been extremely rarely reported. We describe a case of hepatic MALT lymphoma in a 70-year-old male patient who underwent left hepatectomy due to the incidentally detected liver masses at a medical checkup. The resected specimen revealed multinodular masses consisting of small-to-intermediate-sized lymphoid cells with serpentine pattern and focal lymphoepithelial lesions. The tumor cells were diffusely positive for CD20 and Bcl-2 but negative for CD3, CD10, CD5, CD23, CD43, and cyclinD1. The Ki-67 labeling index was 10% and immunoglobulin heavy chain gene rearrangement study confirmed monoclonal proliferation. In this paper, we discuss several unique clinicopathologic characteristics which will be helpful to the differential diagnosis of hepatic MALT lymphoma.

Citations

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Oral administration of Limosilactobacillus reuteri VHProbi® M07 alleviates ovalbumin-induced allergic asthma in mice
Guoqing Meng, Hongchang Cui, Congrui Feng, Chaoqun Guo, Lei Song, Zhi Duan, Misbahuddin Rafeeq
PLOS ONE.2025; 20(1): e0317587. CrossRef
Response‑adapted involved site radiation therapy for hepatic marginal zone B‑cell lymphoma: A case report
Shin-Ting Chen, Yu-Guang Chen, Wen-Yen Huang, Cheng-Hsiang Lo
Oncology Letters.2025;[Epub] CrossRef
Management approaches for primary hepatic lymphoma: 10 year institutional experience with comprehensive literature review
Jennifer Ma, Remy Daou, Josiane Bou Eid, Beatrice Fregonese, Joe El-Khoury, N. Ari Wijetunga, Brandon S. Imber, Joachim Yahalom, Carla Hajj
Frontiers in Oncology.2025;[Epub] CrossRef
Primary Hepatic Mucosa-Associated B-Cell Lymphoma in a Patient with Primary Sclerosing Cholangitis—A Case Ultimately Requiring Liver Transplantation
Jerica Novak, Mihajlo Đokić, Miha Petrič, Diana Vozlič, Milanka Živanović, Branislava Ranković, Blaž Trotovšek
Diagnostics.2025; 15(16): 2082. CrossRef
Primary hepatic mucosa-associated lymphoid tissue lymphoma: a case report and literature review
Tao He, Jieyu Zou
Frontiers in Oncology.2024;[Epub] CrossRef
“Speckled Enhancement” on Gd-EOB-DTPA Enhanced MR Imaging of Primary Hepatic Mucosa-associated Lymphoid Tissue Lymphoma
Ryota Hyodo, Yasuo Takehara, Ayumi Nishida, Masaya Matsushima, Shinji Naganawa
Magnetic Resonance in Medical Sciences.2023; 22(3): 273. CrossRef
Primary hepatic extranodal marginal zone B-cell mucosa-associated lymphoid tissue lymphoma treated by laparoscopic partial hepatectomy: a case report
Keisuke Okura, Satoru Seo, Hironori Shimizu, Hiroto Nishino, Tomoaki Yoh, Ken Fukumitsu, Takamichi Ishii, Koichiro Hata, Hironori Haga, Etsuro Hatano
Surgical Case Reports.2023;[Epub] CrossRef
Incidental Findings in Pediatric Patients: How to Manage Liver Incidentaloma in Pediatric Patients
Andrius Cekuolis, Dagmar Schreiber-Dietrich, Rasa Augustinienė, Heike Taut, Judy Squires, Edda L. Chaves, Yi Dong, Christoph F. Dietrich
Cancers.2023; 15(8): 2360. CrossRef
Primary hepatic mucosa‐associated lymphoid tissue lymphoma: Case report and literature review
Wing Yu Lau, Kit‐Man Ho, Fiona Ka‐Man Chan, Shi Lam, Kai‐Chi Cheng
Surgical Practice.2022; 26(1): 56. CrossRef
18F-FDG Versus 68Ga-FAPI PET/CT in Visualizing Primary Hepatic Extranodal Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue
Yizhen Pang, Long Zhao, Qihang Shang, Tinghua Meng, Haojun Chen
Clinical Nuclear Medicine.2022; 47(4): 375. CrossRef
Primary hepatopancreatobiliary lymphoma: Pathogenesis, diagnosis, and management
Qianwen Wang, Kangze Wu, Xuzhao Zhang, Yang Liu, Zhouyi Sun, Shumei Wei, Bo Zhang
Frontiers in Oncology.2022;[Epub] CrossRef
Positive effect of Bifidobacterium animalis subsp. lactis VHProbi YB11 in improving gastrointestinal movement of mice having constipation
Hongchang Cui, Qian Wang, Congrui Feng, Chaoqun Guo, Jingyan Zhang, Xinping Bu, Zhi Duan
Frontiers in Microbiology.2022;[Epub] CrossRef
A case of primary hepatic extranodal marginal zone B-cell mucosa-associated lymphoid tissue (MALT) lymphoma treated by radiofrequency ablation (RFA), and a literature review
Zhe Xu, Chong Pang, Jidong Sui, Zhenming Gao
Journal of International Medical Research.2021;[Epub] CrossRef

Original Article

A scoring system for the diagnosis of non-alcoholic steatohepatitis from liver biopsy: Kyoungbun Lee, Eun Sun Jung, Eunsil Yu, Yun Kyung Kang, Mee-Yon Cho, Joon Mee Kim, Woo Sung Moon, Jin Sook Jeong, Cheol Keun Park, Jae-Bok Park, Dae Young Kang, Jin Hee Sohn, So-Young Jin; J Pathol Transl Med. 2020;54(3):228-236. Published online April 15, 2020; DOI: https://doi.org/10.4132/jptm.2020.03.07

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Abstract PDF

Background
Liver biopsy is the essential method to diagnose non-alcoholic steatohepatitis (NASH), but histological features of NASH are too subjective to achieve reproducible diagnoses in early stages of disease. We aimed to identify the key histological features of NASH and devise a scoring model for diagnosis.
Methods
Thirteen pathologists blindly assessed 12 histological factors and final histological diagnoses (‘not-NASH,’ ‘borderline,’ and ‘NASH’) of 31 liver biopsies that were diagnosed as non-alcoholic fatty liver disease (NAFLD) or NASH before and after consensus. The main histological parameters to diagnose NASH were selected based on histological diagnoses and the diagnostic accuracy and agreement of 12 scoring models were compared for final diagnosis and the NAFLD Activity Score (NAS) system.
Results
Inter-observer agreement of final diagnosis was fair (κ = 0.25) before consensus and slightly improved after consensus (κ = 0.33). Steatosis at more than 5% was the essential parameter for diagnosis. Major diagnostic factors for diagnosis were fibrosis except 1C grade and presence of ballooned cells. Minor diagnostic factors were lobular inflammation ( ≥ 2 foci/ × 200 field), microgranuloma, and glycogenated nuclei. All 12 models showed higher inter-observer agreement rates than NAS and post-consensus diagnosis (κ = 0.52–0.69 vs. 0.33). Considering the reproducibility of factors and practicability of the model, summation of the scores of major (× 2) and minor factors may be used for the practical diagnosis of NASH.
Conclusions
A scoring system for the diagnosis of NAFLD would be helpful as guidelines for pathologists and clinicians by improving the reproducibility of histological diagnosis of NAFLD.

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Motahareh Taghizadeh, Mohammad Hasan Maleki, Omid Vakili, Ramin Tavakoli, Parvin Zarei, Amirreza Dehghanian, Hossein Bordbar, Sayed Mohammad Shafiee
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Marlone Cunha-Silva, Luíza D. Torres, Mariana F. Fernandes, Tirzah de M. Lopes Secundo, Marina C.G. Moreira, Ademar Yamanaka, Leonardo T. Monici, Larissa B. Eloy da Costa, Daniel F. Mazo, Tiago Sevá-Pereira
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Marlone Cunha-Silva, Luíza D. Torres, Mariana F. Fernandes, Tirzah de M. Lopes Secundo, Marina C.G. Moreira, Ademar Yamanaka, Leonardo T. Monici, Larissa B. Eloy da Costa, Daniel F. Mazo, Tiago Sevá-Pereira
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Case Studies

Adrenal Cortical Neoplasm with Uncertain Malignant Potential Arising in the Heterotopic Adrenal Cortex in the Liver of a Patient with Beckwith-Wiedemann Syndrome: Eun Na Kim, Dong Eun Song, Hee Mang Yoon, Beom Hee Lee, Chong Jai Kim; J Pathol Transl Med. 2019;53(2):129-135. Published online November 26, 2018; DOI: https://doi.org/10.4132/jptm.2018.11.13

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Patients with Beckwith-Wiedemann syndrome (BWS) are predisposed to developing embryonal tumors, with hepatoblastoma being the most common type. Our patient showed hemihypertrophy, macroglossia, and paternal uniparental disomy in chromosome 11 and was diagnosed with BWS. When the patient was 9 months old, a 2.5×1.5 cm oval hypoechoic exophytic mass was detected in the inferior tip of his right liver. Preoperative imaging identified it as hepatoblastoma; however, histologic, immunohistochemistry, and electron microscopic findings were compatible with adrenal cortical neoplasm with uncertain malignant potential. The origin of the adrenal tissue seemed to be heterotopic. Here, we describe for the first time an adrenal cortical neoplasm with uncertain malignant potential arising in the heterotopic adrenal cortex located in the liver of a patient with BWS.

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Molecular and Clinical Features of Adrenocortical Tumors in Beckwith–Wiedemann Spectrum
Diana Carli, Federico Rondot, Maria Luca, Anna Campello, Stefano Gabriele Vallero, Elisa Tirtei, Andrea Gazzin, Simona Cardaropoli, Francesca Montanari, Claudio Graziano, Paola Quarello, Abu Saadat, Angela Sparago, Giovanni Battista Ferrero, Franca Fagiol
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Adrenocortical Tumors in Children With Constitutive Chromosome 11p15 Paternal Uniparental Disomy: Implications for Diagnosis and Treatment
Emilia Modolo Pinto, Carlos Rodriguez-Galindo, Catherine G. Lam, Robert E. Ruiz, Gerard P. Zambetti, Raul C. Ribeiro
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Combined Hepatocellular Carcinoma and Neuroendocrine Carcinoma with Ectopic Secretion of Parathyroid Hormone: A Case Report and Review of the Literature: Hyun Jung Kwon, Ji-Won Kim, Haeryoung Kim, YoungRok Choi, Soomin Ahn; J Pathol Transl Med. 2018;52(4):232-237. Published online May 25, 2018; DOI: https://doi.org/10.4132/jptm.2018.05.17

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Primary combined hepatocellular carcinoma (HCC) and neuroendocrine carcinoma is a rare entity, and so is hypercalcemia due to ectopic parathyroid hormone (PTH) secretion by tumor. A 44-year old man with hepatitis B virus associated chronic liver disease presented with a hepatic mass. Hemihepatectomy discovered the mass as combined HCC and poorly differentiated cholangiocarcinoma. During adjuvant chemoradiation therapy, he presented with nausea, and multiple systemic metastases were found. Laboratory tests revealed hypercalcemia with markedly elevated PTH and neuron specific enolase. Parathyroid scan showed normal uptake in parathyroid glands, suggestive of ectopic PTH secretion. Subsequently, immunohistochemistry of neuroendocrine marker was performed on the primary lesion, and confirmed the neuroendocrine differentiation in non-HCC component. The patient died 71 days after surgery. This report may suggest the possibility of ectopic PTH secretion by neuroendocrine carcinoma of hepatic origin causing hypercalcemia. Caution for neuroendocrine differentiation should be exercised when diagnosing poorly differentiated HCC.

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Magalie Haissaguerre, Estelle Louiset, Christofer C Juhlin, Adam Stenman, Christophe Laurent, Hélène Trouette, Hervé Lefebvre, Antoine Tabarin
European Journal of Endocrinology.2023; 188(4): K11. CrossRef
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Claudio Luchini, Giuseppe Pelosi, Aldo Scarpa, Paola Mattiolo, Deborah Marchiori, Roberta Maragliano, Fausto Sessa, Silvia Uccella
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Akira Nakano, Kenichi Hirabayashi, Hiroshi Yamamuro, Taro Mashiko, Yoshihito Masuoka, Seiichiro Yamamoto, Soji Ozawa, Toshio Nakagohri
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Severe hypercalcaemia from ectopic intact parathyroid hormone secretion treated with continuous renal replacement therapy in a patient with two malignancies
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Filomena Cetani, Elena Pardi, Claudio Marcocci
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Primary hepatic neuroendocrine cancer coexisted with hepatocellular carcinoma: a case report
Chikara Ebisutani, Seitetsu Yoon, Toshiki Hyodo, Takafumi Watanabe, Hirofumi Okada, Yutaka Shirakawa, Yoshio Sakamoto, Shigeya Hirohata
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Jia-Xi Mao, Fei Teng, Ke-Yan Sun, Cong Liu, Guo-Shan Ding, Wen-Yuan Guo
Hepatobiliary & Pancreatic Diseases International.2020; 19(4): 399. CrossRef
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Qi Xin, Rong Lv, Cheng Lou, Zhe Ma, Gui-Qiu Liu, Qin Zhang, Hai-Bo Yu, Chuan-Shan Zhang
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Mixed hepatocellular carcinoma-neuroendocrine carcinoma—A diagnostic and therapeutic challenge
Nusrat Jahan, Irfan Warraich, Edwin Onkendi, Sanjay Awasthi
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Hepatocellular Carcinoma Arising in a Huge Hepatocellular Adenoma with Bone Marrow Metaplasia: Hyo Jeong Kang, Hui Jeong Jeong, So-Woon Kim, Eunsil Yu, Young-Joo Lee, So Yeon Kim, Jihun Kim; J Pathol Transl Med. 2018;52(4):226-231. Published online December 27, 2017; DOI: https://doi.org/10.4132/jptm.2017.11.12

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Hepatocellular adenoma (HCA) is the most common type of benign liver tumor, and its major complication is malignant transformation to hepatocellular carcinoma (HCC). Here, we report a case of HCC arising in HCA with bone marrow metaplasia in a 24-year-old Korean woman who presented with abdominal discomfort. A huge liver mass was found on abdominal ultrasonography. She underwent surgical hepatic resection, and the resected specimen was entirely involved by a 20-cm-sized tumor. Histological review revealed a well differentiated HCC arising from inflammatory HCA with β-catenin nuclear positivity and bone marrow metaplasia that contained hematopoietic cells. This case was unique because malignant transformation, inflammatory type HCA, β-catenin nuclear staining, and bone marrow metaplasia were simultaneously observed. Additionally, it should be noted that a large HCA with β-catenin activation can undergo malignant transformation and should be surgically resected in a timely manner.

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Adult Hepatocellular Carcinoma Coexisting with Extramedullary Hematopoiesis
Hirotsugu Noguchi, Michiyo Higashi, Ryo Desaki, Takashi Tasaki, Mari Kirishima, Ikumi Kitazono, Kazuhiro Tabata, Akihide Tanimoto
International Journal of Surgical Pathology.2022; 30(3): 339. CrossRef
Spontaneous Occurrence of Various Types of Hepatocellular Adenoma in the Livers of Metabolic Syndrome-Associated Steatohepatitis Model TSOD Mice
Wenhua Shao, Orgil Jargalsaikhan, Mayuko Ichimura-Shimizu, Qinyi Cai, Hirohisa Ogawa, Yuko Miyakami, Kengo Atsumi, Mitsuru Tomita, Mitsuko Sutoh, Shunji Toyohara, Ryoji Hokao, Yasusei Kudo, Takeshi Oya, Koichi Tsuneyama
International Journal of Molecular Sciences.2022; 23(19): 11923. CrossRef
Bilateral Diffuse Nodular Pulmonary Ossification Mimicking Metastatic Disease in a Patient with Fibrolamellar Hepatocellular Carcinoma
Pattamon Sutthatarn, Cara E. Morin, Jessica Gartrell, Wayne L. Furman, Max R. Langham, Teresa Santiago, Andrew J. Murphy
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Malignant transformation of liver fatty acid binding protein-deficient hepatocellular adenomas: histopathologic spectrum of a rare phenomenon
Juan Putra, Linda D. Ferrell, Annette S.H. Gouw, Valerie Paradis, Arvind Rishi, Christine Sempoux, Charles Balabaud, Swan N. Thung, Paulette Bioulac-Sage
Modern Pathology.2020; 33(4): 665. CrossRef
Hepatocellular carcinoma arising from hepatic adenoma in a young woman
Haythem Yacoub, Hela Kchir, Dhouha Cherif, Hajer Hassine, Slim Haouet, Asma Ayari, Habiba Mizouni, Saber Mannai, Mohamed Tahar Khalfallah, Nadia Maamouri
Clinical Case Reports.2020; 8(9): 1659. CrossRef
Metanephric adenoma with osseous metaplasia and bone marrow elements
Alessandro Pietro Aldera, Jeff John, Dharshnee Chetty, Dhirendra Govender
Human Pathology: Case Reports.2019; 17: 200316. CrossRef

Erdheim-Chester Disease Involving Lymph Nodes and Liver Clinically Mimicking Lymphoma: A Case Report: Yeoun Eun Sung, Yoon Seo Lee, Jieun Lee, Kyo Young Lee; J Pathol Transl Med. 2018;52(3):183-190. Published online December 27, 2017; DOI: https://doi.org/10.4132/jptm.2017.10.16

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Abstract PDF

Erdheim-Chester disease (ECD) is a rare non-Langerhans cell histiocytosis and multisystem disease. First described in 1930, there are no more than 750 cases reported. The etiology remains unknown, but a majority of cases of ECD and Langerhans cell histiocytosis were found to have clonal mutations involving genes of the mitogen-activated protein kinase pathway. We recently encountered a 53-year-old male patient with extensive ECD involving the systemic lymph nodes, pleura, liver, and long bones clinically mimicking malignant lymphoma. Biopsies were performed at multiple sites, including a pleural mass, an external iliac lymph node, bone marrow, and the liver. Based on histopathological and immunohistochemical findings of positivity for CD68 and negativity for CD1a and S-100, the patient was diagnosed with ECD. Interferon-α was administered as the first-line treatment, but the patient rapidly progressed to hepatic failure after 2 months of treatment. We report this rare case of ECD clinically mimicking malignant lymphoma and diagnosed by careful pathological review.

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Original Articles

Prognosis of Hepatocellular Carcinoma after Liver Transplantation: Comparative Analysis with Partial Hepatectomy: Kyuho Lee, Kyoung-Bun Lee, Nam-Joon Yi, Kyung-Suk Suh, Ja-June Jang; J Pathol Transl Med. 2017;51(1):79-86. Published online December 25, 2016; DOI: https://doi.org/10.4132/jptm.2016.10.13

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Abstract PDF

Background
Liver transplantation (LT) is the treatment of choice for hepatocellular carcinoma (HCC). The aim of this study was to investigate the recurrence rate of HCC after LT and prognostic factors for recurrence by comparing LT with non-transplanted resection. Methods: The participants were 338 patients who underwent LT between 1996 and 2012 at Seoul National University Hospital (LT group) and 520 HCC patients who underwent partial hepatectomy between 1995 and 2006 (control group, non-LT group). Results: In the LT group, 68 of 338 patients (19.8%) showed relapse, and the recurrence rate was lower than that in the non-LT group (64.9%, 357/520, p < .001). Stratification analysis by American Joint Committee on Cancer (AJCC) stage showed that the stage I-II LT group had a lower recurrence rate than the non-LT group. Univariate comparative analysis demonstrated that multiplicity of tumor, tumor size, gross type, Edmondson- Steiner (ES) nuclear grade, extent of tumor, angioinvasion, AJCC stage, Milan criteria, University of California at San Francisco criteria on explant pathology (all p < .001), positive expression of cytokeratin 19 (p = .002), and preoperative α-fetoprotein (AFP) (p < .001) were predictors of tumor recurrence. In multivariate analysis, LT, preoperative AFP, multiplicity of tumor, extent of tumor, size of tumor, and ES nuclear grade were independent prognostic factors. Conclusions: LT might have a protective effect against the late recurrence of stage I-II HCC compared to non-LT, and the prognostic factors for recurrence were similar to previously well-known prognostic factors for HCC.

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Locoregional and Surgical Treatment of Single-Nodule Hepatocellular Carcinoma Recurrence After Liver Transplantation: A Systematic Review and a Meta-Analysis
Marco Maria Pascale, Camilla Marandola, Francesco Frongillo, Erida Nure, Salvatore Agnes
Cancers.2025; 17(9): 1501. CrossRef
Risk Factor Analysis of Death in Patients With Hepatic Cellular Carcinoma After Radical Operation: A Consecutive Cohort of 433 Patients
Zhengyang He, Wenfeng Lu, Dongze Qiu, Weimin She
Health Science Reports.2025;[Epub] CrossRef
Related Factors of Hepatocellular Carcinoma Recurrence Associated With Hyperglycemia After Liver Transplantation
Yujian Zheng, Qing Cai, Lishan Peng, Shibo Sun, Shaoping Wang, Jie Zhou
Transplantation Proceedings.2021; 53(1): 177. CrossRef
Oncological Outcomes of Hepatic Resection vs Transplantation for Localized Hepatocellular Carcinoma
A.T. Akcam, A.G. Saritas, A. Ulku, A. Rencuzogullari
Transplantation Proceedings.2019; 51(4): 1147. CrossRef
Clustering Asian Countries According to the Trend of liver cancer Mortality Rates: an Application of Growth Mixture Models
Maryam Salari, Anoshirvan Kazemnejad, Farid Zayeri
Iranian Red Crescent Medical Journal.2017;[Epub] CrossRef

Clinicopathologic Correlations of E-cadherin and Prrx-1 Expression Loss in Hepatocellular Carcinoma: Kijong Yi, Hyunsung Kim, Yumin Chung, Hyein Ahn, Jongmin Sim, Young Chan Wi, Ju Yeon Pyo, Young-Soo Song, Seung Sam Paik, Young-Ha Oh; J Pathol Transl Med. 2016;50(5):327-336. Published online August 31, 2016; DOI: https://doi.org/10.4132/jptm.2016.06.22

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Abstract PDF

Background
Developing predictive markers for hepatocellular carcinoma (HCC) is important, because many patients experience recurrence and metastasis. Epithelial to mesenchymal transition (EMT) is a developmental process that plays an important role during embryogenesis and also during cancer metastasis. Paired-related homeobox protein 1 (Prrx-1) is an EMT inducer that has recently been introduced, and its prognostic significance in HCC is largely unknown.
Methods
Tissue microarray was constructed using surgically resected primary HCCs from 244 cases. Immunohistochemical staining of E-cadherin and Prrx-1 was performed. The correlation between E-cadherin loss and Prrx-1 expression, as well as other clinicopathologic factors, was evaluated.
Results
E-cadherin expression was decreased in 96 cases (39.4%). Loss of E-cadherin correlated with a higher recurrence rate (p < .001) but was not correlated with patient’s survival. Thirty-two cases (13.3%) showed at least focal nuclear Prrx-1 immunoreactivity while all non-neoplastic livers (n = 22) were negative. Prrx-1 expression was not associated with E-cadherin loss, survival or recurrence rates, pathologic factors, or the Ki-67 labeling index. Twenty tumors that were positive for E-cadherin and Prrx-1 had significantly higher nuclear grades than the rest of the cohort (p = .037). In Cox proportional hazard models, E-cadherin loss and large vessel invasion were independent prognostic factors for shorter disease-free survival. Cirrhosis and high Ki-67 index (> 40%) were independent prognostic factors for shorter overall survival.
Conclusions
Prrx-1 was expressed in small portions of HCCs but not in normal livers. Additional studies with a large number of Prrx-1-positive cases are required to confirm the results of this study.

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Matrigel and collagen I impact hepatocellular carcinoma cell behavior: a confluency-dependent study
Zeynep Akbulut, Can Daylan, Gamze Demirel
Cukurova Medical Journal.2025; 50(3): 899. CrossRef
The Prognostic Importance of Ki-67 in Gastrointestinal Carcinomas: A Meta-analysis and Multi-omics Approach
Mahdieh Razmi, Fatemeh Tajik, Farideh Hashemi, Ayna Yazdanpanah, Fatemeh Hashemi-Niasari, Adeleh Divsalar
Journal of Gastrointestinal Cancer.2024; 55(2): 599. CrossRef
Homotypic cell-in-cell structures as an adverse prognostic predictor of hepatocellular carcinoma
Ruizhi Wang, Yichao Zhu, Hao Zhong, Xinyue Gao, Qiang Sun, Meifang He
Frontiers in Oncology.2022;[Epub] CrossRef
Dysregulated paired related homeobox 1 impacts on hepatocellular carcinoma phenotypes
Weronika Piorońska, Zeribe Chike Nwosu, Mei Han, Michael Büttner, Matthias Philip Ebert, Steven Dooley, Christoph Meyer
BMC Cancer.2021;[Epub] CrossRef

Interobserver Agreement on Pathologic Features of Liver Biopsy Tissue in Patients with Nonalcoholic Fatty Liver Disease: Eun Sun Jung, Kyoungbun Lee, Eunsil Yu, Yun Kyung Kang, Mee-Yon Cho, Joon Mee Kim, Woo Sung Moon, Jin Sook Jeong, Cheol Keun Park, Jae-Bok Park, Dae Young Kang, Jin Hee Sohn, So-Young Jin; J Pathol Transl Med. 2016;50(3):190-196. Published online April 18, 2016; DOI: https://doi.org/10.4132/jptm.2016.03.01

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Abstract PDF

Background
The histomorphologic criteria for the pathological features of liver tissue from patients with non-alcoholic fatty liver disease (NAFLD) remain subjective, causing confusion among pathologists and clinicians. In this report, we studied interobserver agreement of NAFLD pathologic features and analyzed causes of disagreement.
Methods
Thirty-one cases of clinicopathologically diagnosed NAFLD from 10 hospitals were selected. One hematoxylin and eosin and one Masson’s trichrome-stained virtual slide from each case were blindly reviewed with regard to 12 histological parameters by 13 pathologists in a gastrointestinal study group of the Korean Society of Pathologists. After the first review, we analyzed the causes of disagreement and defined detailed morphological criteria. The glass slides from each case were reviewed a second time after a consensus meeting. The degree of interobserver agreement was determined by multi-rater kappa statistics.
Results
Kappa values of the first review ranged from 0.0091–0.7618. Acidophilic bodies (k = 0.7618) and portal inflammation (k = 0.5914) showed high levels of agreement, whereas microgranuloma (k = 0.0984) and microvesicular fatty change (k = 0.0091) showed low levels of agreement. After the second review, the kappa values of the four major pathological features increased from 0.3830 to 0.5638 for steatosis grade, from 0.1398 to 0.2815 for lobular inflammation, from 0.1923 to 0.3362 for ballooning degeneration, and from 0.3303 to 0.4664 for fibrosis.
Conclusions
More detailed histomorphological criteria must be defined for correct diagnosis and high interobserver agreement of NAFLD.

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Review

Idiopathic Noncirrhotic Portal Hypertension: An Appraisal: Hwajeong Lee, Aseeb Ur Rehman, M. Isabel Fiel; J Pathol Transl Med. 2016;50(1):17-25. Published online November 11, 2015; DOI: https://doi.org/10.4132/jptm.2015.09.23

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Abstract PDF

Idiopathic noncirrhotic portal hypertension is a poorly defined clinical condition of unknown etiology. Patients present with signs and symptoms of portal hypertension without evidence of cirrhosis. The disease course appears to be indolent and benign with an overall better outcome than cirrhosis, as long as the complications of portal hypertension are properly managed. This condition has been recognized in different parts of the world in diverse ethnic groups with variable risk factors, resulting in numerous terminologies and lack of standardized diagnostic criteria. Therefore, although the diagnosis of idiopathic noncirrhotic portal hypertension requires clinical exclusion of other conditions that can cause portal hypertension and histopathologic confirmation, this entity is under-recognized clinically as well as pathologically. Recent studies have demonstrated that variable histopathologic entities with different terms likely represent a histologic spectrum of a single entity of which obliterative portal venopathy might be an underlying pathogenesis. This perception calls for standardization of the nomenclature and formulation of widely accepted diagnostic criteria, which will facilitate easier recognition of this disorder and will highlight awareness of this entity.

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Original Article

Mdm2 and p53 Expression in Radiation-Induced Sarcomas of the Head and Neck: Comparison with De Novo Sarcomas: Min Jeong Song, Joon Seon Song, Jong-Lyel Roh, Seung-Ho Choi, Soon Yuhl Nam, Sang Yoon Kim, Sung Bae Kim, Sang-wook Lee, Kyung-Ja Cho; Korean J Pathol. 2014;48(5):346-350. Published online October 27, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.5.346

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Abstract PDF

Background: The pathogenesis of radiation-induced sarcomas (RISs) is not well known. In RIS, TP53 mutations are frequent, but little is known about Mdm2-p53 interaction, which is a recent therapeutic target of sarcomas. Methods: We studied the immunohistochemical expression of Mdm2 and p53 of 8 RISs. The intervals between radiation therapy and diagnosis of secondary sarcomas ranged from 3 to 17 years. Results: Mdm2 expression was more common in de novo sarcomas than RISs (75% vs 37.5%), and p53 expression was more common in RISs than in de novo cases (75% vs 37.5%). While half of the RISs were Mdm2(–)/p53(+), none of de novo cases showed such combination; while half of de novo sarcomas were Mdm2(+)/p53(–), which are a candidate group of Mdm2 inhibitors, only 1 RIS showed such a combination. Variable immunoprofiles observed in both groups did not correlate with tumor types, except that all of 2 myxofibrosarcomas were Mdm2(+)/p53(+). Conclusions: In conclusion, we speculated that both radiation- induced and de novo sarcomagenesis are not due to a unique genetic mechanism. Mdm2- expression without p53 overexpression in 1 case of RIS decreases the future possibility of applying Mdm2 inhibitors on a subset of these difficult tumors.

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Radiation-induced osteosarcoma in the head and neck region: Case report and literature review
Iara Vieira Ferreira, Marcelo Elias Schempf Cattan, Carlos Takahiro Chone, Arthur Antolini, Erika Said Abu Egal, Albina Altemani, Fernanda Viviane Mariano
Oral Oncology.2025; 162: 107216. CrossRef
Radiation-Induced Sarcomas of the Head and Neck: A Systematic Review
Andrés Coca-Pelaz, Antti A. Mäkitie, Primož Strojan, June Corry, Avraham Eisbruch, Jonathan J. Beitler, Sandra Nuyts, Robert Smee, Johannes A. Langendijk, William M. Mendenhall, Cesare Piazza, Alessandra Rinaldo, Alfio Ferlito
Advances in Therapy.2021; 38(1): 90. CrossRef
Genomic Characterization of Radiation-Induced Intracranial Undifferentiated Pleomorphic Sarcoma
Christopher S. Hong, Edwin Partovi, James Clune, Anita Huttner, Henry S. Park, Sacit Bulent Omay, Balraj Mittal
Case Reports in Genetics.2021; 2021: 1. CrossRef
Radiation-Induced Sarcoma of the Head and Neck: A Review of the Literature
Lorenzo Giannini, Fabiola Incandela, Marco Fiore, Alessandro Gronchi, Silvia Stacchiotti, Claudia Sangalli, Cesare Piazza
Frontiers in Oncology.2018;[Epub] CrossRef

Case Study

Primary Myxoid Leiomyoma of the Liver: Hee Seung Choi, Chang Won Jung, Soo Youn Cho, Sang Bum Kim, Sunhoo Park; Korean J Pathol. 2014;48(1):54-57. Published online February 25, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.1.54

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Abstract PDF

Herein, we report a case of primary myxoid leiomyoma of the liver. A 60-year-old woman complained of upper abdominal fullness. Computed tomography showed a solid tumor (8 cm) in the liver. The patient underwent right hepatectomy and histological findings from the resected specimen revealed scattered bland spindle cells in a background of exuberant myxoid material. The tumor cells were immunoreactive for smooth muscle actin and desmin. No other lesions were found elsewhere in the body. Thus, the tumor was diagnosed as a primary myxoid leiomyoma of the liver.

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Hepatic Myxoid Leiomyoma: A Very Rare Tumor
João Fraga, Rui Caetano Oliveira, Luigi Terracciano, Mário Rui Silva, Maria Augusta Cipriano
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Suk Hyun Jang, Sun Moon Kim, Jang Sihn Sohn, Ki Hyun Ryu, Hyung Bin Yuk
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Original Article

Clinicopathological Analysis of Hepatocellular Adenoma According to New Bordeaux Classification: Report of Eight Korean Cases: Hyunchul Kim, Ja-June Jang, Dong-Sik Kim, Beom Woo Yeom, Nam Hee Won; Korean J Pathol. 2013;47(5):411-417. Published online October 25, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.5.411

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Abstract PDF

Background

Hepatocellular adenoma (HCA) is a rare benign tumor of the liver. A subtype classification of HCA (hepatocyte nuclear factor 1α [HNF1α]-mutated, β-catenin-mutated HCA, inflammatory HCA, and unclassified HCA) has recently been established based on a single institutional review of a HCA series by the Bordeaux group.

Methods

We used histologic and immunohistochemical parameters to classify and evaluate eight cases from our institution. We evaluated the new classification method and analyzed correlations between our results and those of other reports.

Results

Seven of our eight cases showed histologic and immunohistochemical results consistent with previous reports. However, one case showed overlapping histologic features, as previously described by the Bordeaux group. Four cases showed glutamine synthetase immunohistochemical staining inconsistent with their classification, indicating that glutamine synthetase staining may not be diagnostic for β-catenin-mutated HCA. HNF1α-mutated HCA may be indicated by the absence of liver fatty acid binding protein expression. Detection of amyloid A may indicate inflammatory HCA. HCA with no mutation in the HNF1α or β-catenin genes and no inflammatory protein expression is categorized as unclassified HCA.

Conclusions

Although the new classification is now generally accepted, validation through follow-up studies is necessary.

Citations

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Megan A. Nocita, Carla W. Brady, Jeffrey A. Kuller, Luke A. Gatta
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Brent K. Larson, Maha Guindi
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Sounak Gupta, Bita V. Naini, Richard Munoz, Rondell P. Graham, Benjamin R. Kipp, Michael S. Torbenson, Taofic Mounajjed
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Taofic Mounajjed, Saba Yasir, Patrice A Aleff, Michael S Torbenson
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Case Studies

Fine Needle Aspiration Cytology of Hepatic Hydatid Cyst: A Case Study: Ae Ri Kim, Seok Ju Park, Mi Jin Gu, Joon Hyuk Choi, Hong Jin Kim; Korean J Pathol. 2013;47(4):395-398. Published online August 26, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.4.395

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Abstract PDF

Hydatid cysts (echinococcosis) are caused by an infestation with larval tapeworms of the genus Echinococcus. The disease is extensively distributed worldwide, and it has been rarely reported in Korea. We describe the cytologic features of a case of hepatic hydatid cyst in a 28-year-old male. Computed tomography revealed a cystic mass in the right lobe of the liver. A right hemihepatectomy was performed. The aspirated fluid from the hepatic cystic mass was clear. The smears showed protoscolices, hooklets, and a laminated membrane.

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Won Jun Choi, Hanna Jin, Hyeon Jae Jo, Chan Mi Lee, Chang Kyung Kang, Pyoeng Gyun Choe, Wan Beom Park, Nam Joong Kim, Min-Ho Choi
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Multicystic Biliary Hamartoma of the Liver: Ji Soo Song, Sang Jae Noh, Baik Hwan Cho, Woo Sung Moon; Korean J Pathol. 2013;47(3):275-278. Published online June 25, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.3.275

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Abstract PDF

Multicystic biliary hamartoma (MCBH) is a very rare hamartomatous cystic nodule of the liver, which has recently been described as a new entity of a hepatic nodular lesion. We report a unique case of MCBH with a review of the literatures. A hepatic multicystic mass of segment 3 was detected in a 52-year-old male by abdominal computed tomography, and resection of this lesion was performed. Macroscopic examination revealed a 2.7×2.0 cm nodular mass with a multicystic honeycomb cut surface. Histologically, this lesion consisted of multiple dilated cystic ducts lined by biliary type epithelial cells, periductal glands and connective tissue, which included small amounts of hepatic parenchyma and blood vessels. Recognition of this unusual lesion is essential to avoid confusion with other cystic tumors of the liver, and to learn more about its natural history and response to treatment.

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Gautham Krishnamurthy, Harjeet Singh, Sravya Deepika Ganti, Ganga Ram Verma
Journal of Gastrointestinal Cancer.2019; 50(4): 1022. CrossRef
A variant of multicystic biliary hamartoma presenting as an intrahepatic cystic neoplasm
Tetsuro Tominaga, Takafumi Abo, Naoe Kinoshita, Tomonori Murakami, Yasunori Sato, Yasuni Nakanuma, Kenich Harada, Junichi Masuda, Takeshi Nagayasu, Atsushi Nanashima
Clinical Journal of Gastroenterology.2015; 8(3): 162. CrossRef
Hamartoma biliar multiquístico intrahepático: presentación de un caso clínico
María Jezabel Fernández-Carrión, Ricardo Robles Campos, Asunción López Conesa, Roberto Brusadín, Pascual Parrilla Paricio
Cirugía Española.2015; 93(9): e103. CrossRef
Intrahepatic Multicystic Biliary Hamartoma: Presentation of a Case Report
María Jezabel Fernández-Carrión, Ricardo Robles Campos, Asunción López Conesa, Roberto Brusadín, Pascual Parrilla Paricio
Cirugía Española (English Edition).2015; 93(9): e103. CrossRef
Multicystic biliary hamartoma: A report of a rare entity and a review of the literature
Rachel E. Beard, Eric U. Yee, Koenraad J. Mortele, Khalid Khwaja
International Journal of Surgery Case Reports.2014; 5(12): 919. CrossRef
Multicystic biliary hamartoma mimicking intrahepatic cholangiocarcinoma: report of a case
Tomoaki Yoh, Ryuji Okamura, Hiroyuki Nakayama, Xue Lin, Yuya Nakamura, Tatsushi Kato
Clinical Journal of Gastroenterology.2014; 7(5): 418. CrossRef

Original Articles

Histopathological Causes of Late Liver Allograft Dysfunction: Analysis at a Single Institution: Eun Shin, Ji Hoon Kim, Eunsil Yu; Korean J Pathol. 2013;47(1):21-27. Published online February 25, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.1.21

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Abstract PDF

Background

We summarize our experience in the pathological diagnosis of late complications of liver transplantation (LT) to better understand the causes of late allograft dysfunction in a population mostly composed of patients with hepatitis B virus (HBV) infection.

Methods

We reviewed 361 post-transplant liver biopsies from 174 patients who underwent LT and first presented with liver function abnormalities 3 months post-procedure. The underlying diseases included HBV-associated liver disease (77%), toxic or alcoholic liver disease (10.3%), hepatitis C virus (HCV)-associated liver disease (8.6%), primary biliary cirrhosis (1.2%), primary sclerosing cholangitis (1.2%), and metabolic disease (1.7%).

Results

The three most common late complications were acute rejection (32.5%), recurrent disease (19.1%), and biliary complication (17.1%). Patients who underwent LT for HBV infection or for drug- or alcohol-related liver disease had a lower incidence of recurring disease than those who underwent transplantation for HCV infection. During post-transplantation months 3-12, acute rejection was the most common cause of allograft dysfunction and recurring disease was the leading cause for allograft dysfunction (p=0.039). The two primary causes of late allograft dysfunction have overlapping histological features, although acute rejection more frequently showed bile duct damage and vascular endothelialitis than recurring HBV infection, and recurring HBV infection had more frequent lobular activity and piecemeal necrosis.

Conclusions

The causes of late liver allograft dysfunction are closely associated with the original liver diseases and the period after LT. Careful attention is required for differential diagnosis between acute rejection and recurrent HBV.

Citations

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Renal Allograft Pathology Classifications: Contemporary Updates and Diagnostic Utility
Hussein Qasim, Hamza Abuuqteish, Karis Khattab, Matteo Luigi Giuseppe Leoni , Giustino Varrassi
Cureus.2025;[Epub] CrossRef
Liver Transplantation from a Human Leukocyte Antigen-Matched Sibling Donor: Effectiveness of Direct-Acting Antiviral Therapy against Hepatitis C Virus Infection
Tatsuo Kanda, Naoki Matsumoto, Tomotaka Ishii, Shuhei Arima, Shinji Shibuya, Masayuki Honda, Reina Sasaki-Tanaka, Ryota Masuzaki, Shini Kanezawa, Masahiro Ogawa, Shintaro Yamazaki, Osamu Aramaki, Hirofumi Kogure, Yukiyasu Okamura
Reports.2022; 5(4): 49. CrossRef
A comparative histological analysis of early and late graft dysfunction in different time zones following living donor liver transplantation
Archana Rastogi, Nayana Patil, Sphurti Srivastava, Gayatri Ramakrishna, Rakhi Maiwal, Guresh Kumar, Ashok K. Choudhary, Seema Alam, Chhagan Bihari, Viniyendra Pamecha
Indian Journal of Pathology and Microbiology.2022; 65(4): 802. CrossRef
Differences in risk factors for early-onset and late-onset biliary complications in liver transplant patients
Hsiu-Lung Fan, An-Chieh Feng, Meng-Hsing Ho, Shih-Ming Kuo, Wei-Chou Chang, Teng-Wei Chen
Journal of Medical Sciences.2015; 35(5): 201. CrossRef
Vitamin C exerts beneficial hepatoprotection against Concanavalin A-induced immunological hepatic injury in mice through inhibition of NF-κB signal pathway
Tao Liang, Xiaoyu Chen, Min Su, Hongqiu Chen, Guozhe Lu, Kun Liang
Food & Function.2014; 5(9): 2175. CrossRef

The Histologic Cut-off Point for Adjacent and Remote Non-neoplastic Liver Parenchyma of Hepatocellular Carcinoma in Chronic Hepatitis B Patients: Hae Yoen Jung, Soo Hee Kim, Jin Jing, Jae Moon Gwak, Chul Ju Han, Ja-June Jang, Kyoung-Bun Lee; Korean J Pathol. 2012;46(4):349-358. Published online August 23, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.4.349

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Abstract PDF

Background

The molecular profile of peritumoral non-neoplastic liver parenchyma (PNLP) has recently been suggested as predictive factor of early and late recurrence of hepatocellular carcinoma (HCC). However, there is no definite cut-off point for tumor-free PNLP in terms of either histological or molecular changes. Therefore, our aim is to determine the numerical cut-off point for separating adjacent PNLP and remote PNLP in histopathologic perspective.

Methods

Peritumoral tissues from 20 resected HCC patients were sampled from 0 to 40 mm distance from the tumor border (divided into 5-mm columns). Histopathologic parameters such as necroinflammatory activity, fibrosis, bile ductular reaction, hepatic venulitis, peliosis, and steatosis were compared between each column.

Results

The morphologic changes just adjacent to the tumor were notably severe and faded with distance. The parenchyma within 10 mm of the tumor showed significantly severe inflammation, fibrosis, peliosis and hepatic venulitis compared with those from farther areas. The histopathologic changes of the parenchyma became stable beyond 20 mm.

Conclusions

Results of this study revealed that the parenchyma within 10 mm distance from the tumor, or adjacent PNLP, has histopathologic changes that are directly affected by the tumor, and the parenchyma beyond 20 mm as the remote PNLP without tumor effect.

Citations

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Does very high alpha-fetoprotein affect very early hepatocellular carcinoma receiving hepatectomy?
Hong-Shiue Chou, Chen-Fang Lee, Hao-Chien Hung, Yin Lai, Jin-Chiao Lee, Yu-Chao Wang, Chih-Hsien Cheng, Tsung-Han Wu, Ting-Jung Wu, Kun-Ming Chan, Wei-Chen Lee
Langenbeck's Archives of Surgery.2025;[Epub] CrossRef
Evaluation of the effects of dimethyl fumarate on transforming growth factor beta levels in the liver of rats with bile duct ligation-induced cholestasis
Hannaneh Vossoughi, Pejman Mortazavi, Mahsa Ale-Ebrahim, Razieh Hosseini
Toxicology Reports.2025; 15: 102115. CrossRef
Peritumoral histopathologic findings in patients with chronic viral hepatitis‐associated hepatocellular carcinoma
Burcin Pehlivanoglu, Anil Aysal, Cihan Agalar, Tufan Egeli, Mucahit Ozbilgin, Tarkan Unek, Tugba Unek, Ilhan Oztop, Ozgul Sagol
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Prognostic value of non-invasive fibrosis indices post-curative resection in hepatitis-B-associated hepatocellular carcinoma patients
Ting-Ting Zhang, Si-Si Ye, Jun Liang, Li Bai
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Evaluation of Peritumoral Fibrosis in Metastatic Colorectal Adenocarcinoma to the Liver Using Digital Image Analysis
Kevin M Waters, Tricia R Cottrell, Sepideh Besharati, Qingfeng Zhu, Robert A Anders
American Journal of Clinical Pathology.2019; 151(2): 226. CrossRef
Fibrosis-4 Model Influences Results of Patients with Hepatocellular Carcinoma Undergoing Hepatectomy
Haiqing Wang, Aixiang Liu, Wentao Bo, Xielin Feng, Yong Hu, Lang Tian, Hui Zhang, Xiaoli Tang, Lixia Zhang
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Forns index predicts recurrence and death in patients with hepatitis B‐related hepatocellular carcinoma after curative resection
Won‐Mook Choi, Jeong‐Hoon Lee, Hongkeun Ahn, Hyeki Cho, Young Youn Cho, Minjong Lee, Jeong‐ju Yoo, Yuri Cho, Dong Hyeon Lee, Yun Bin Lee, Eun Ju Cho, Su Jong Yu, Nam‐Joon Yi, Kwang‐Woong Lee, Yoon Jun Kim, Jung‐Hwan Yoon, Kyung‐Suk Suh, Chung Yong Kim, Hy
Liver International.2015; 35(8): 1992. CrossRef
Renal Histologic Parameters Influencing Postoperative Renal Function in Renal Cell Carcinoma Patients
Myoung Ju Koh, Beom Jin Lim, Kyu Hun Choi, Yon Hee Kim, Hyeon Joo Jeong
Korean Journal of Pathology.2013; 47(6): 557. CrossRef

Chemotherapy-Associated Hepatopathy in Korean Colorectal Cancer Liver Metastasis Patients: Oxaliplatin-Based Chemotherapy and Sinusoidal Injury: Soo Jeong Nam, Jai Young Cho, Hye Seung Lee, Gheeyoung Choe, Ja June Jang, Yoo-Seok Yoon, Ho-Seong Han, Haeryoung Kim; Korean J Pathol. 2012;46(1):22-29. Published online February 23, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.1.22

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Abstract PDF

Background

Although chemotherapy-related hepatic injury has been reported in colorectal cancer liver metastasis (CRLM) patients, the morphologic changes caused by chemotherapeutic agents and the effect of chemotherapy on postoperative outcome remain ill-defined. A comprehensive review of the morphologic changes in the post-chemotherapy non-neoplastic liver was performed and the clinical effect of preoperative chemotherapy in CRLM patients was analyzed.

Methods

Hematoxylin-eosin, Masson's trichrome and reticulin-stained slides from non-neoplastic livers obtained from 89 CRLM patients were analyzed, and the clinicopathologic features were correlated with the status of chemotherapy exposure.

Results

Histopathologic features of sinusoidal injury (sinusoidal dilatation, centrilobular perivenular fibrosis, parenchymal extinction lesions, small vessel obliteration, and hepatocyte plate disruption) were significantly more frequent in oxaliplatin-exposed livers (p<0.05). The extent of sinusoidal dilatation was positively correlated with increasing numbers of chemotherapy cycles (p=0.022). Abnormal preoperative liver function tests were more frequently seen (p<0.05) and postoperative total bilirubin was higher in the chemotherapy group (p=0.008). Postoperative morbidity was more common in the chemotherapy group (p=0.044).

Conclusions

Sinusoidal injury is frequently seen in oxaliplatin-treated livers, and its presence, especially when extensive, should be documented in surgical pathology practice. The recognition of sinusoidal injury may provide helpful guidelines for surgeons in deciding the extent of hepatic resection.

Citations

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Model establishment and microarray analysis of mice with oxaliplatin‑induced hepatic sinusoidal obstruction syndrome
Chen Zhu, Xinwei Cheng, Ping Gao, Qianyan Gao, Ximin Wang, Dong Liu, Xiuhua Ren, Chengliang Zhang
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Oxaliplatin-induced hepatic sinusoidal obstruction syndrome
Chen Zhu, Xiuhua Ren, Dong Liu, Chengliang Zhang
Toxicology.2021; 460: 152882. CrossRef
Hepatic steatosis in patients undergoing resection of colorectal liver metastases: A target for prehabilitation? A narrative review
D.T. Doherty, P.O. Coe, L. Rimmer, S. Lapsia, A. Krige, D.A. Subar
Surgical Oncology.2019; 30: 147. CrossRef
Protective effect of Korean red ginseng on oxaliplatin-mediated splenomegaly in colon cancer
Jeonghyun Kang, Joon Seong Park, Sung Gwe Ahn, Jin Hong Lim, Seung Hyuk Baik, Dong Sup Yoon, Kang Young Lee, Joon Jeong
Annals of Surgical Treatment and Research.2018; 95(3): 161. CrossRef
Use of Imaging to Predict Complete Response of Colorectal Liver Metastases after Chemotherapy: MR Imaging versus CT Imaging
Min Jung Park, Nurhee Hong, Kyunghwa Han, Min Ju Kim, Yoon Jin Lee, Yang Shin Park, Sung Eun Rha, Sumi Park, Won Jae Lee, Seong Ho Park, Chang Hee Lee, Chung Mo Nam, Chansik An, Hye Jin Kim, Honsoul Kim, Mi-Suk Park
Radiology.2017; 284(2): 423. CrossRef
Systematic review of the influence of chemotherapy-associated liver injury on outcome after partial hepatectomy for colorectal liver metastases
J Zhao, K M C van Mierlo, J Gómez-Ramírez, H Kim, C H C Pilgrim, P Pessaux, S S Rensen, E P van der Stok, F G Schaap, O Soubrane, T Takamoto, L Viganò, B Winkens, C H C Dejong, S W M Olde Damink, I García Sanz, E Martín Pérez, J Y Cho, Y R Choi, W Phillip
British Journal of Surgery.2017; 104(8): 990. CrossRef
Hepatic Lesions that Mimic Metastasis on Radiological Imaging during Chemotherapy for Gastrointestinal Malignancy: Recent Updates
Sung-Hye You, Beom Jin Park, Yeul Hong Kim
Korean Journal of Radiology.2017; 18(3): 413. CrossRef
Changes in Noninvasive Liver Fibrosis Indices and Spleen Size During Chemotherapy
Sehhoon Park, Hwi Young Kim, Haeryoung Kim, Jin Hyun Park, Jung Ho Kim, Ki Hwan Kim, Won Kim, In Sil Choi, Yong Jin Jung, Jin-Soo Kim
Medicine.2016; 95(2): e2454. CrossRef
Genetic predisposition resulting in sinusoidal obstruction syndrome in a patient with resected sigmoid cancer on adjuvant oxaliplatin
Si Xuan Koo, Sock Hoai Chan, Joanne Ngeow
BMJ Case Reports.2016; 2016: bcr2015212978. CrossRef
Hepar lobatum carcinomatosum associated with liver metastases from breast cancer: Report of five cases
N. Alberti, D. Bechade, F. Dupuis, A. Crombe, A. Neuville, M. Debled, J. Palussiere, X. Buy, J.-T. Perez, M. Desjardin, N. Frulio, M. Kind
Diagnostic and Interventional Imaging.2015; 96(1): 73. CrossRef
Sinusoidal obstruction syndrome after oxaliplatin-based chemotherapy
An Na Seo, Haeryoung Kim
Clinical and Molecular Hepatology.2014; 20(1): 81. CrossRef
Chemotherapy-induced Focal Hepatopathy in Patients with Gastrointestinal Malignancy: Gadoxetic Acid–enhanced and Diffusion-weighted MR Imaging with Clinical-Pathologic Correlation
Na Yeon Han, Beom Jin Park, Deuk Jae Sung, Min Ju Kim, Sung Bum Cho, Chang Hee Lee, Yun-Jin Jang, So Yeon Kim, Dong Sik Kim, Soon Ho Um, Nam Hee Won, Kyung Sook Yang
Radiology.2014; 271(2): 416. CrossRef
Histopathologic Manifestations of Drug-induced Hepatotoxicity
Xuchen Zhang, Jie Ouyang, Swan N. Thung
Clinics in Liver Disease.2013; 17(4): 547. CrossRef

Clinicopathologic Features of Q Fever Patients with Acute Hepatitis: Miji Lee, Jae Jeong Jang, Yang Soo Kim, Sang-Oh Lee, Sang-Ho Choi, Sung-Han Kim, Eunsil Yu; Korean J Pathol. 2012;46(1):10-14. Published online February 23, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.1.10

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Abstract PDF

Background

Q fever caused by Coxiella burnetii presents with diverse clinical and pathological features including subclinical or cholestatic hepatitis. However, the pathological features of liver biopsies from patients with Q fever have not been well described.

Methods

Clinical features and pathological findings of liver biopsies were reviewed in seven cases of Q fever that were confirmed by serological, microbiological, or molecular tests.

Results

All cases presented with fever. Liver enzymes were mildly elevated except one case with marked hyperbilirubinemia. Characteristic fibrin ring granulomas were present in three cases, epithelioid granulomas with eosinophilic infiltration in two cases, extensive extravasated fibrins without ring configuration mimicking necrotizing granuloma in one case, and acute cholangitis without granuloma in one case. All cases were treated with antibiotics for 20 days. Six cases were completely cured, but one suffered from multiorgan failure.

Conclusions

C. burnetii infection is uncommon, but should always be considered in patients with acute hepatitis and fever. Because variable-sized circumferential or radiating fibrin deposition was a consistent feature of the present cases, Q fever can be strongly suggested by pathological features and confirmed by serological and/or molecular tests.

Citations

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Actualités sur la fièvre Q
Maxime Colson, Matthieu Million, Pierre-Edouard Fournier, Sophie Edouard
Revue Francophone des Laboratoires.2025; 2025(573): 39. CrossRef
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Mohammad Reza Mohammadi, Safoura Moradkasani, Mina Latifian, Saber Esmaeili
Journal of Microbiological Methods.2025; 237: 107213. CrossRef
Q fever as a cause of fever of unknown origin in a patient on hemodialysis
Emilio Guirao-Arrabal, Ana Delgado-Ureña, Elena Borrego-García, Rosa Ríos-Pelegrina
Nefrología.2024; 44(6): 906. CrossRef
Q fever as a cause of fever of unknown origin in a patient on hemodialysis
Emilio Guirao-Arrabal, Ana Delgado-Ureña, Elena Borrego-García, Rosa Ríos-Pelegrina
Nefrología (English Edition).2024; 44(6): 906. CrossRef
(Seltene) infektiöse Hepatitiden als wichtige Differenzialdiagnose der unklaren Hepatopathie
Michael Wührl, Marc Ringelhan, Ursula Ehmer, Jochen Schneider, Juliane Kager, Tobias Lahmer, Anna Schneider, Wilko Weichert, Carolin Mogler
Die Pathologie.2023; 44(1): 53. CrossRef
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Muhammad Abid Zeeshan, Sarmad Ali, Ishtiaq Ahmed, Aziz ur Rehman, Muhammad Kamran Rafique, Amar Nasir, Aman Ullah Khan, Muhammad Kashif, Katja Mertens-Scholz, Muhammad Imran Arshad, Syed Ehtisham-ul-Haque, Heinrich Neubauer
Frontiers in Veterinary Science.2023;[Epub] CrossRef
The First Case of Coxiella Burnetti Infection Detected Through Bone Marrow Biopsy in Vietnam
Do Thi Vinh An, Bui Thi Viet Ha, Dao Xuan Co, Vu Minh Tam, Le Thi Diem Tuyet, Vu Van Truong
Clinical Pathology.2022;[Epub] CrossRef
Pathological study and molecular detection of zoonotic diseases in small ruminants at slaughter houses in Mymensingh, Bangladesh
Nazneen Sultana, Munmun Pervin, Sajeda Sultana, Mahmuda Islam, Moutuza Mostaree, Mohammad Abu Hadi Noor Ali Khan
Veterinary World.2022; : 2119. CrossRef
The First Report of Coxiella burnetii as a Potential Neglected Pathogen of Acute Hepatitis of Unknown Causes in Egypt
Mohamed A. El-Mokhtar, Ibrahim M. Sayed, Ayat M. Kamel, Ahmed Atef Mesalam, Elsayed A. Elgohary, Khaled Abo bakr Khalaf, Sara Adel, Azza Abo Elfadl, Walaa A. Khalifa, Haidi Karam-Allah Ramadan
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Lucia Zampaglione, Aurélie Bornand, Nicolas Goossens, Lucas Ramer, Giulia Magini, Marie Ongaro, Andreas Cerny, Laura Rubbia-Brandt, Jean-Louis Frossard, Laurent Spahr
Annals of Clinical Gastroenterology and Hepatology.2022; 6(1): 034. CrossRef
Q-fever associated granulomatous hepatitis
Nicolas Dauby, Maria Gomez Galdon, Isabel Montesinos, Marjan Van Esbroeck, Thomas Sersté
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Pathologic changes and immune responses against Coxiella burnetii in mice following infection via non-invasive intratracheal inoculation
Xueyuan Hu, Yonghui Yu, Junxia Feng, Mengjiao Fu, Lupeng Dai, Zhiyu Lu, Wenbo Luo, Jinglin Wang, Dongsheng Zhou, Xiaolu Xiong, Bohai Wen, Baohua Zhao, Jun Jiao, Daniel E. Voth
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Fibrin Ring Granulomas in Checkpoint Inhibitor-induced Hepatitis
Jamie Everett, Amitabh Srivastava, Joseph Misdraji
American Journal of Surgical Pathology.2017; 41(1): 134. CrossRef
Clinical and Genetic Features ofCoxiella burnetiiin a Patient with an Acute Febrile Illness in Korea
Seung Hun Lee, Jung Yeon Heo, Hae Kyung Lee, Yeong Seon Lee, Hye Won Jeong, Seon Do Hwang
Journal of Korean Medical Science.2017; 32(6): 1038. CrossRef
Q Fever Presented as a Large Retroperitoneal Pseudotumoral Mass
Behdokht Nowroozizadeh, Negar Haghighi Mehmandari, Nicolas Gallegos, Mari Perez-Rosendahl, Di Lu
Case Reports in Pathology.2017; 2017: 1. CrossRef
From Q Fever to Coxiella burnetii Infection: a Paradigm Change
Carole Eldin, Cléa Mélenotte, Oleg Mediannikov, Eric Ghigo, Matthieu Million, Sophie Edouard, Jean-Louis Mege, Max Maurin, Didier Raoult
Clinical Microbiology Reviews.2017; 30(1): 115. CrossRef
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Cytologic Diagnosis of hepatocellular Carcinoma by Fine-Needle Aspiration Biopsy.: Ki Kwon Kim, Eun Sook Chang; J Pathol Transl Med. 1990;1(1):18-26.

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Abstract PDF: CT guided percutaneous fine-needle aspiration(FNA) of the liver for both cytologic and histologic examination has great value in diagnosing liver malignancy. From March, 1986 to April, 1990, 62 patients with the clinical impression of liver malignancy underwent CT guided percutaneous FNA biopsy. Of these, 43 cases were reviewed for this study, 19 were reported to be liver cell carcinoma, 2 were adenocarcinoma, 11 were reported as anaplastic cell present, and the rest (11 cases) were negative (9) or necrotic (2). Among the 11 cases of the last group, 9 were diagnosed as liver cell carcinoma and 2 were necrotic histologically. Retrospective review, in order to clarify the casuse of cytologic diagnostic error, of both cytologic and histologic slides of all cases showed discordance of 23% between these diagnoses and sensitivity is 93.9% and specificity is 90.9%. The reasons were as follows :1) the lack of awareness of tumor cells of well differentiated liver cell carcinoma (4 cases), 2) missed tumor cells due to too scanty cellularity (1 case), 3) improper smear (2 cases) and no tumor cell in the cytologic smears (3 cases). In such cases, at the initiation of FNA, a correct diagnosis of liver malignancy could only be made by a combination of cytologic and histologic examinations. However after three years' experience we can conclude that cytomorphologic features of liver cell carcinoma are sufficiently distinctive from other liver malignancies to be diagnostic

Case Reports

Primary Perivascular Epithelioid Cell Tumor (PEComa) of the Liver: A Case Report and Review of the Literature.: Ji Hyun Ahn, Bang Hur; Korean J Pathol. 2011;45:S93-S97.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.S1.S93

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Abstract PDF

Perivascular epithelioid cell tumor (PEComa) is a mesenchymal tumor consisting of distinctive perivascular epithelioid cells, and is commonly detected in the uterus. The liver is an uncommon site for primary PEComa. In this study, we report a case of primary hepatic PEComa in a 36-year-old woman. Upon gross examination, the tumor was a well-defined, brownish solid mass, measuring 6.5x5.2x4.5 cm. Microscopically, the tumor consisted largely of epithelioid cells and some spindle cells with a clear to eosinophilic cytoplasm and a rich network of delicate capillaries in the stroma. With the exception of their relatively large size and microscopically sinusoidal infiltrative growth pattern, all other histopathologic features of the tumor were consistent with their being benign. The tumor cells were positive for human melanoma black-45 and smooth muscle actin, and negative for cytokeratin-cocktail and c-kit.

Citations

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Primary Liver Perivascular Epithelioid Cell Tumor (PEComa): Case Report and Literature Review
Mindaugas Kvietkauskas, Austeja Samuolyte, Rokas Rackauskas, Raminta Luksaite-Lukste, Gintare Karaliute, Vygante Maskoliunaite, Ruta Barbora Valkiuniene, Vitalijus Sokolovas, Kestutis Strupas
Medicina.2024; 60(3): 409. CrossRef
Unresectable hepatic PEComa: a rare malignancy treated with stereotactic body radiation therapy (SBRT) followed by complete resection
Simon Kirste, Gian Kayser, Anne Zipfel, Anca-Ligia Grosu, Thomas Brunner
Radiation Oncology.2018;[Epub] CrossRef
Hepatic perivascular epithelioid cell tumor (PEComa): a case report with a review of literatures
Hyun Jin Son, Dong Wook Kang, Joo Heon Kim, Hyun Young Han, Min Koo Lee
Clinical and Molecular Hepatology.2017; 23(1): 80. CrossRef
Malignant hepatic perivascular epithelioid cell tumor (PEComa) – Case report and a brief review
Banerjee Abhirup, Kundalia Kaushal, Mehta Sanket, Nagarajan Ganesh
Journal of the Egyptian National Cancer Institute.2015; 27(4): 239. CrossRef
Hepatic falciform ligament clear cell myomelanocytic tumor: A case report and a comprehensive review of the literature on perivascular epithelioid cell tumors
Zu-Sen Wang, Lin Xu, Lin Ma, Meng-Qi Song, Li-Qun Wu, Xuan Zhou
BMC Cancer.2015;[Epub] CrossRef
Improving recognition of hepatic perivascular epithelioid cell tumor: Case report and literature review
Toshiya Maebayashi
World Journal of Gastroenterology.2015; 21(17): 5432. CrossRef
Primary perivascular epithelioid cell tumor of the liver: new case report and literature review
Hassania Ameurtesse, Laïla Chbani, Amal Bennani, Imane Toughrai, Nouhad Beggui, Imane Kamaoui, Hinde Elfatemi, Taoufik Harmouch, Afaf Amarti
Diagnostic Pathology.2014;[Epub] CrossRef
Hepatic perivascular epithelioid cell tumor (PEComa): dynamic CT, MRI, ultrasonography, and pathologic features—analysis of 7 cases and review of the literature
Yan Tan, En-hua Xiao
Abdominal Radiology.2012; 37(5): 781. CrossRef

Clinicopathologic Analysis of the Liver Explant with Severe Hepatitis A Virus Infection.: Joo Young Kim, Sung Gyu Lee, Shin Hwang, Ji Hoon Kim, Se Jin Jang, Eunsil Yu; Korean J Pathol. 2011;45:S48-S52.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.S1.S48

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Abstract PDF: The incidence of severe hepatitis A virus (HAV) infection has been increasing. However, clinicopathologic features of severe HAV infection that lead to liver transplantation (LT) have not been reported in Korea. We retrieved 16 LT cases with HAV infection during the last 3 years at Asan Medical Center, Seoul, Korea. Fifteen cases progressed to hepatic encephalopathy. Thirteen cases survived with or without complications, and three patients died of sepsis. The explanted liver showed massive or zonal necrosis with moderate to severe cholestasis. The zonal distribution of necrosis was frequently associated with endothelialitis of portal and/or central veins. Degenerative changes of hepatocytes were various in degree and distribution. Viral inclusions were suspected in two cases. Although HAV infection is usually confirmed by serological tests, significant venulitis of central and/or portal veins and viral inclusions, which are rarely observed, can suggest an HAV infection as a cause of massive hepatic necrosis of unknown mechanism.

Bile Ductular Proliferation in the Gastric Wall after Gastric Ulcer Penetration into the Liver.: Eun Jung Cha; Korean J Pathol. 2011;45(4):434-436.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.4.434

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Abstract PDF: Liver penetration is one of the most serious complications of peptic ulcer diseases but is rarely encountered. A 57-year-old man was admitted to our hospital for further evaluation of a gastric malignancy. One month before admission, he was diagnosed with an adenocarcinoma by endoscopic biopsy at other hospital. A subtotal gastrectomy was performed to confirm malignancy and relieve the epigastric pain. Histologically, single glands were located between the ulcer base and attached liver tissue and stained positively for cytokeratin 19. The pathologic diagnosis was a gastric ulcer and bile ductular proliferation in the liver and gastric wall. Here, this report is the first Korean case of liver penetration of a gastric ulcer.

Primary Hepatic Neuroblastoma: A Case Report.: Geunyoung Jung, Jihun Kim; Korean J Pathol. 2011;45(4):423-427.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.4.423

4,822 View
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Abstract PDF

Neuroblastoma is a malignant tumor of primordial neural crest origin. It usually develops along the sympathetic nervous system, such as the adrenal glands or paramedian sympathetic chain and metastasizes to the liver most frequently. However, a primary hepatic neuroblastoma has not been reported yet. Here, we report a case of 29-year-old woman who presented with a solitary hepatic mass. Grossly, the mass was large, creamy, rubbery firm, and showed focal hemorrhage and central cavitation. Microscopically, the tumor cells were arranged in small nests of spindle to ovoid cells with abundant neuropil. The neuroblastic nature of the tumor was confirmed by immunohistochemistry and electron microscopy. No extrahepatic mass was found, despite a thorough systemic survey such as chest and abdominopelvic computed tomography (CT) scans and a whole body positron emission tomography-CT study. To the best of our knowledge, this is the first report of a bona fide primary hepatic neuroblastoma.

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Primary hepatic neuroblastoma in a 19-month-old child: A case report
Jovana Dimić, Dejan Skorić, Aleksandar Sretenović, Slaviša Đuričić
Medicinska istrazivanja.2022; 55(2): 41. CrossRef
Morphologic Alteration of Metastatic Neuroblastic Tumor in Bone Marrow after Chemotherapy
Go Eun Bae, Yeon-Lim Suh, Ki Woong Sung, Jung-Sun Kim
Korean Journal of Pathology.2013; 47(5): 433. CrossRef

Original Article

Newly Formed Hepatic Masses in Children with Biliary Atresia after Kasai Hepatic Portoenterostomy.: Hye Jong Song, Yeon Lim Suh; Korean J Pathol. 2011;45(2):160-169.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.2.160

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Abstract PDF

BACKGROUND
This report describes the clinicopathologic findings of six hepatic masses that developed after Kasai hepatic portoenterostomy (HPE) in six patients with longstanding biliary atresia (BA).
METHODS
Hepatic masses were found in six of 55 pediatric patients who underwent liver transplantation for BA after Kasai HPE from 1997 to 2009. Clinicopathologic analysis was performed and immunohistochemical staining was carried out for CD34, smooth muscle actin (SMA) and cytokeratin 7.
RESULTS
Of the six hepatic masses, two were diagnosed as focal nodular hyperplasia (FNH)-like lesions, two were large regenerative nodules (LRN), one was a mesenchymal hamartoma (MH) and one was a cholangiocarcinoma. The immunohistochemical staining findings for SMA and CD34 were more prominent for the FNH-like nodules than for the cirrhotic background liver. Dysplastic biliary epithelium arising from intestinal metaplasia was found in the cholangiocarcinoma.
CONCLUSIONS
Our findings suggest that FNH-like lesions, LRNs and MH are the results of vascular hemodynamic changes after Kasai HPE and that cholangiocarcinoma is due to recurrent cholangitis after BA. All the lesions in this series must be included in the differential diagnosis of a newly formed hepatic mass in patients after portoenterostomy.

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Imaging Findings and Management Strategies for Liver Masses in Children with Predisposition Disorders: A Review by the Pediatric LI-RADS Group
Amy B. Kolbe, Michael R. Acord, Geetika Khanna, Cara E. Morin, HaiThuy N. Nguyen, Mitchell A. Rees, Esther Ro, Gary R. Schooler, Judy H. Squires, Ali B. Syed, Elizabeth R. Tang, Alexander J. Towbin, Adina Alazraki
RadioGraphics.2025;[Epub] CrossRef
Features of Nodules in Explants of Children Undergoing Liver Transplantation for Biliary Atresia
Ana M. Calinescu, Anne-Laure Rougemont, Mehrak Anooshiravani, Nathalie M. Rock, Valerie A. McLin, Barbara E. Wildhaber
Journal of Clinical Medicine.2022; 11(6): 1578. CrossRef
Biliary Atresia Patients With Successful Kasai Portoenterostomy Can Present With Features of Obliterative Portal Venopathy
Kalyani R. Patel, Sanjiv Harpavat, Zahida Khan, Sadhna Dhingra, Norma Quintanilla, Mihail Firan, John Goss
Journal of Pediatric Gastroenterology and Nutrition.2020; 71(1): 91. CrossRef

Case Reports

Solitary Fibrous Tumor of the Liver: A Case Report.: Hee Chul Yu, Baik Hwan Cho, Young Kon Kim, Sang Jae Noh, Woo Sung Moon; Korean J Pathol. 2010;44(5):536-539.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.5.536

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Abstract PDF

Solitary fibrous tumor is an uncommon neoplasm of mesenchymal origin that primarily affects the pleura. This tumor has been rarely found in liver parenchyma. We present an additional case of a solitary fibrous tumor in the liver of a 46-year-old woman. A contrast-enhanced magnetic resonance image revealed a well-defined round hepatic mass with strong homogeneous enhancement on arterial phase imaging. The tumor was composed of cytologically bland spindle cells with alternating hypercellular and hypocellular sclerotic areas. Immunohistochemistry indicated that the tumor cells were positive for vimentin, CD34, CD99 and smooth muscle actin, but negative for cytokeratin, human melanoma black 45, CD117, bcl-2, and S-100 protein.

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Meningeal Solitary Fibrous Tumors with Delayed Extracranial Metastasis
Nayoung Han, Hannah Kim, Soo Kee Min, Sun-Ha Paek, Chul-Kee Park, Seung-Hong Choi, U-Ri Chae, Sung-Hye Park
Journal of Pathology and Translational Medicine.2016; 50(2): 113. CrossRef

Intraductal Papillary Mucinous Tumor Simultaneously Involving the Liver and Pancreas: A Case Report.: Bong Hee Park, Jae Hee Suh, Hee Jeong Cha, Young Min Kim, Hye Jeong Choi; Korean J Pathol. 2010;44(1):83-86.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.1.83

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Abstract PDF

We describe here a 67-year-old man who was diagnosed with a rare case of intraductal papillary mucinous tumors that occurred simultaneously in the liver and pancreas. Abdominal computed tomography showed a tubular and cystic dilatation of the pancreatic duct in the pancreas tail, which suggested an intraductal papillary mucinous tumor (IPMT), and multiple intrahepatic duct stones. The patient underwent a distal pancreatectomy with splenectomy and a lateral segmentectomy of the liver. Microscopic examination showed an intraductal papillary mucinous neoplasms of borderline malignancy in the pancreas and a non-invasive intraductal papillary mucinous tumor with moderate dysplasia of the bile duct. Although several cases of intraductal papillary mucinous neoplasm of the liver (IPNL) without any pancreatic association have been described, the simultaneous presentation of both IPMT of the pancreas and IPNL is very rare. The patient has been doing well for 10 months postoperatively.

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Surgical resection for simultaneous intraductal papillary mucinous neoplasm of the bile duct and pancreatic duct: A case report
Xiao-Rui Huang, Deng-Sheng Zhu, Ya-Hong Yu
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
Reoperation for heterochronic intraductal papillary mucinous neoplasm of the pancreas after bile duct neoplasm resection: A case report
Gang Xiao, Tao Xia, Yi-Ping Mou, Yu-Cheng Zhou
World Journal of Gastrointestinal Surgery.2023; 15(7): 1542. CrossRef
Intraductal papillary neoplasm of the bile duct: The new frontier of biliary pathology
Federico Mocchegiani, Paolo Vincenzi, Grazia Conte, Daniele Nicolini, Roberta Rossi, Andrea Benedetti Cacciaguerra, Marco Vivarelli
World Journal of Gastroenterology.2023; 29(38): 5361. CrossRef
Multicentric recurrence of intraductal papillary neoplasm of bile duct after spontaneous detachment of primary tumor: A case report
Hiroki Fukuya, Akifumi Kuwano, Shigehiro Nagasawa, Yusuke Morita, Kosuke Tanaka, Masayoshi Yada, Akihide Masumoto, Kenta Motomura
World Journal of Clinical Cases.2022; 10(3): 1000. CrossRef
Co-occurrence of IPMN and malignant IPNB complicated by a pancreatobiliary fistula: A case report and review of the literature
Xu Ren, Chun-Lan Zhu, Xu-Fu Qin, Hong Jiang, Tian Xia, Yong-Ping Qu
World Journal of Clinical Cases.2019; 7(1): 102. CrossRef
Synchronous pancreatic adenocarcinoma and intrahepatic cholangiocarcinoma arising in the context of intraductal papillary neoplasms
Anmol Bansal, Swan N. Thung, Hongfa Zhu, Myron Schwartz, Sara Lewis
Clinical Imaging.2016; 40(5): 897. CrossRef

Original Articles

Characterization of Histopathological Features that Differentiate Hepatitis B Virus Infection from Acute Cellular Rejection.: Dong Eun Song, Dong Hwan Jung, Shin Hwang, Bong Hee Park, Eunsil Yu; Korean J Pathol. 2009;43(6):535-541.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.6.535

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Abstract PDF

BACKGROUND
Differentiation of viral hepatitis from acute cellular rejection (ACR) after liver transplantation can be difficult because of overlapping histological features. Here we investigated clinicopathologic characteristics of 311 liver allograft biopsies and searched for characteristic histopathological features that would facilitate the differential diagnosis between hepatitis B virus (HBV) infection and ACR. METHODS: A retrospective clinicopathologic examination of 311 liver allograft biopsies consisting of clinically proven ACR or HBV infection was performed. Immunohistochemical staining for HBcAg and HBsAg was done for 64 allograft biopsies showing HBV infection. RESULTS: Moderate to severe bile duct damage, diffuse centrilobular necrosis and centrilobular inflammation (p<0.000, for each) were more frequently observed in cases of ACR, whereas diffuse acidophilic bodies and spotty necrosis (p<0.000, for each) were more prevalent in cases of HBV infection. Immunopositivity for HBcAg (n=60, 93.8%) was higher than that for HBsAg (n=14, 21.9%) CONCLUSIONS: The presence of moderate to severe bile duct damage, diffuse centrilobular necrosis and centrilobular inflammation was a characteristic feature of ACR, whereas diffuse distribution of acidophilic bodies or spotty necrosis was the only characteristic feature of HBV infection. HBcAg was a more sensitive immunohistochemical marker than HBsAg for detecting HBV infection in liver allograft biopsies.

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Analysis of S Gene Mutation of the Hepatitis B Virus in Adult Liver Transplant Recipients Showing Resistance to Hepatitis B Immunoglobulin Therapy
G.-C. Park, S. Hwang, C.-S. Ahn, K.-H. Kim, D.-B. Moon, T.-Y. Ha, G.-W. Song, D.-H. Jung, Y.W. Shin, S.-H. Kim, K.-H. Chang, J.-M. Namgoong, C.-S. Park, H.-W. Park, Y.-H. Park, S.-H. Kang, B.-H. Jung, S.-G. Lee
Transplantation Proceedings.2013; 45(8): 3047. CrossRef
Posttransplantation prophylaxis with primary high-dose hepatitis B immunoglobulin monotherapy and complementary preemptive antiviral add-on a
Shin Hwang, Chul-Soo Ahn, Gi-Won Song, Ki-Hun Kim, Deok-Bog Moon, Heung-Bum Oh, Young-Suk Lim, Han Chu Lee, Tae-Yong Ha, Dong-Hwan Jung, Young-Hwa Chung, Sung-Gyu Lee
Liver Transplantation.2011; 17(4): 456. CrossRef
Posttransplantation Prophylaxis with Primary High-dose Hepatitis B Immunoglobulin Monotherapy and Complementary Preemptive Antiviral Add-on. Liver Transpl 2011;17:456-465
Dong-Hwan Jung, Shin Hwang
The Korean Journal of Gastroenterology.2011; 57(5): 330. CrossRef

Expression and Prognostic Significance of Serum Response Factor in Cholangiocarcinoma.: Shin Young Park, Kyu Yun Jang, Yo Na Kim, Hee Jin Kim, Ho Sung Park, Myoung Ja Chung, Hee Chul Yu, Baik Hwan Cho, Kyoung Ryul Kim, Woo Sung Moon; Korean J Pathol. 2009;43(6):517-522.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.6.517

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Abstract PDF

BACKGROUND
Serum response factor (SRF) is a transcriptional factor that plays an important role in cell growth and differentiation for several types of cells. The expression of SRF in cholangiocarcinoma (CC) and its potential role has not been examined. The aim of this study was to determine the relationship between the expression of SRF in CC and the clinicopathological parameters, as well as patient survival.
METHODS
We analyzed the expression of SRF in 84 surgically resected cases of CC (33 cases of intrahepatic CC [ICC] and 51 cases of extrahepatic CC [ECC]) by using immunohistochemistry. RESULTS: The positive expression of SRF was detected in 48.8% of the cases of CC (42.4% in ICC, 52.9% in ECC). SRF was predominantly expressed in the CC cells with intense labeling in the nucleus. A SRF expression was significantly associated with the cell proliferation rate (Ki-67 labeling index, p=0.046) and poor patient survival (p=0.002). The tumor differentiation (p=0.038), the T category (p<0.001), lymph node and distant metastasis (p<0.001, p=0.009) and nerve and vessel invasion (p=0.010, p=0.012) were also found to be significantly associated with a poor CC prognosis. CONCLUSIONS: These results suggest that the SRF may play a role in the tumor cell proliferation of CC, and its expression in tumor cells can provide additional prognostic information.

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Serum response factor induces epithelial to mesenchymal transition with resistance to sorafenib in hepatocellular carcinoma
JUN SANG BAE, SANG JAE NOH, KYOUNG MIN KIM, KYU YUN JANG, MYOUNG JA CHUNG, DAE GOHN KIM, WOO SUNG MOON
International Journal of Oncology.2014; 44(1): 129. CrossRef
Clinicopathologic significance of serum response factor expression in colorectal adenocarcinomas
Se Min Jang, Young Jin Jun, Hulin Han, Kang Hong Lee, Ki-Seok Jang, Seung Sam Paik
Basic and Applied Pathology.2011; 4(2): 46. CrossRef

Transcriptional Regulation of Hepatic Stellate Cell Activation by siRNA for TGF-beta1.: Hoon Kyu Oh, Kyung Hyun Kim, Yoon Sup Keum, Chang Ho Cho, Jae Bok Park, Kwan Kyu Park; Korean J Pathol. 2009;43(6):503-508.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.6.503

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Abstract PDF

BACKGROUND
The cytokine-induced activation of hepatic stellate cells (HSC) plays a major role in liver fibrosis. Quiescent HSCs undergo phenotypic transformation called "transdifferentiation" in response to viral, chemical or immune insults to the liver. The cytokine TGF-beta1 plays a key role in progressive liver fibrosis. Since small interfering RNA (siRNA) is a powerful tool for silencing gene expression post-transcriptionally, the present study aimed to determine whether synthetic TGF-beta1 siRNA down-regulates the expression of the TGF-beta1 gene in immortalized and activated rat HSCs (HSC-T6s). The study examined whether synthetic TGF-beta1 siRNA prevents rat HSCs activation and extracellular matrix (ECM) production.
METHODS
TGF-beta1 siRNA or a control (pU6) siRNA was added to HSC-T6 culture media. We then performed RT-PCR and western blot analyses for TGF-beta1 and ECM components (fibronectin, type-I collagen, and TIMP-1). RESULTS: TGF-beta1 siRNA significantly down-regulated expression of TGF-beta1 mRNA and protein and attenuated mRNA and protein expressions of type-I collagen, fibronectin, and TIMP-1, as compared to the control. CONCLUSIONS: TGF-beta1 siRNA can effectively down-regulate the expression of TGF-beta1 in rat HSC, resulting in significant inhibition of HSC activation and of ECM production. These data indicate that synthetic TGF-beta1 siRNA can be a useful treatment modality to prevent liver fibrosis.

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Glaucocalyxin A Attenuates the Activation of Hepatic Stellate Cells Through the TGF-β1/Smad Signaling Pathway
Zhichao Dong, Qi Gao, Hao Guo
DNA and Cell Biology.2018; 37(3): 227. CrossRef

Case Report

Morphological Features of Metastatic Gastrointestinal Stromal Tumors after Gleevec Treatment: Two Cases Report.: Joon Hyuk Choi, Young Kyung Bae, Sun Kyo Song, Hong Jin Kim, Min Chul Shim, Kyung Hee Lee; Korean J Pathol. 2009;43(4):368-373.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.4.368

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Abstract PDF: We report two patients with metastatic gastrointestinal stromal tumors (GISTs) with a focus on the morphological features related to Gleevec treatment. In case 1, a 50-year-old woman presented with a 1.8 cm metastatic GIST in the liver after resection of a gastric GIST. Majority of the metastatic tumor showed fibrosis and hyalinization after 8 weeks of Gleevec treatment. CD117-positive cells were present in approximately 1% of the overall tumor. In case 2, a 2 cm and 14 cm metastatic liver masses were found in a 54-year-old man who had a rectal GIST. After 4 weeks of Gleevec treatment, metastatic tumors showed a decrease in size on CT scan. The metastatic tumors showed a decrease in number of tumor cells. The hemorrhage, cystic changes, necrosis, and fibrosis made up approximately 90% of the tumor. The morphological features related to Gleevec treatment are important for correct diagnosis and evaluation of tumor response and prognosis.

Original Articles

Immunohistochemical Study about the Origin of Bile Ductules Proliferation in Obstructive Liver Disease.: Hyun Jung Sung, Byung Chul Ann, Jae Tae Lee, Yoon Seup Kum, Jae Bok Park, Kwan Kyu Park; Korean J Pathol. 2009;43(2):126-132.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.2.126

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Abstract PDF: BACKGROUND
The relationship between bile duct proliferation and portal fibrosis in obstructive liver diseases remains unclear. The purpose of this study is to analyze the relationship between hepatic stellate cells (HSC), hepatocytes and bile ductule proliferation in obstructive liver disease using immunoreactivity for alpha-SMA (alpha-smooth muscle actin), CK7, and CK19.
METHODS
We used 20 human tissue samples with hepatic fibrosis due to intrahepatic stones and liver cirrhosis. Immunohistochemical staining was performed using the streptavidin-biotin method.
RESULTS
Proliferations of bile ductules at the periphery of the hepatic lobules, and diffuse HSC activation in the perisinusoidal spaces were observed in all cases. Immunoreactivity of the hepatocytes for CK7 and CK19 suggested a possible phenotypic transformation into bile duct epithelium during fibrogenesis. Immunohistochemical-analyses of alpha-SMA expression profiles showed that intralobular HSCs and some hepatocytes underwent early phenotypic changes, and that the accumulation of collagen coincides with that of alpha-SMA-labeled myofibroblasts around portal/septal ductular structures.
CONCLUSIONS
Our results showed the possibility of a phenotypic transformation of hepatocytes into bile ductular epithelium. It is suggested that hepatocytes might play a role in bile ductule proliferation in obstructive liver disease.

Alteration of Bile Acid Transporter Expression in Patients with Early Cholestasis Following Living Donor Liver Transplantation.: Eun Sun Jung, Byung Kee Kim, So Youn Kim, Youn Soo Lee, Si Hyun Bae, Seung Kew Yoon, Jong Young Choi, Young Min Park, Dong Goo Kim; Korean J Pathol. 2009;43(1):48-55.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.1.48

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Abstract PDF: BACKGROUND
Intrahepatic cholestasis can occur early after living donor liver transplantation (LDLT). We investigated the changes in the expressions of the bile acid transporters and the liver histology in the patients who suffered with early cholestasis (EC) following LDLT.
METHODS
The histological differences between 15 graft livers with EC after LDLT and 5 graft livers with biliary stricture following LDLT were evaluated. The hepatic mRNA levels of the bile canaliculi transporters (BSEP, MRP2, MRP3, MDR1, MDR3, NTCP) in 40 (20 graft livers, 20 matched donor livers) liver biopsy tissues were analyzed by performing real-time reverse-transcription polymerase chain reaction (RT-PCR).
RESULTS
Microscopic examination revealed hepatocellular and/or bile canalicular cholestasis around acinar zone 3 in the livers of the patients with EC. In the livers with biliary stricture, the cholestasis was dominantly observed in the hepatocytic cytoplasm and in the bile ductules around the portal area rather than around acinar zone 3. The BSEP and MRP2 mRNA levels in the EC livers were significantly reduced by 44% and 23%, respectively (p=0.000), compared to the matched donor livers. The levels of MDR3 and NTCP mRNA in the EC livers increased by 738% (p=0.000) and 281% (p<0.01), respectively. The change of the expressions of the bile acid transporters in the patients with biliary stricture was less significant than that in the EC group.
CONCLUSIONS
These results suggest that the altered expressions of the bile acid transporters may play a role in the pathogenesis of EC following LDLT.

Case Report

Imprint Cytology of Hepatic Angiomyolipoma: A Case Report.: Ae Ri Kim, Hong Jin Kim, Joon Hyuk Choi; J Pathol Transl Med. 2008;19(2):188-193.; DOI: https://doi.org/10.3338/kjc.2008.19.2.188

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Abstract PDF

Angiomyolipoma of the liver is a rare benign tumor that's composed of variable mixtures of adipose tissue, smooth muscle and thick-walled blood vessels. We report here on the imprint cytologic features of a hepatic angiomyolipoma in a 47-year-old man. The smears showed spindle and epithelioid tumor cells in clusters, trabeculae and single cells. The spindle cells had elongated, cigar-shaped nuclei with finely granular chromatin and fibrillary cytoplasm. The epithelioid cells had round nuclei with a moderate amount of cytoplasm. Any adipose tissue was not found. Immunohistochemically, both the spindle and epithelioid cells revealed cytoplasmic positivity for smooth muscle actin and HMB-45.

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Hepatic Angiomyolipoma with Variable Histologic Features: 8 Cases Resembling Hepatocellular Carcinoma or Inflammatory Pseudotumor
Ilseon Hwang, Eunsil Yu, Kyung-Ja Cho
The Korean Journal of Gastroenterology.2012; 60(4): 242. CrossRef
Hepatic epithelioid angiomyolipoma with trabecular growth pattern: A mimic of hepatocellular carcinoma on fine needle aspiration cytology
Linjun Xie, Jose Jessurun, J. Carlos Manivel, Stefan E. Pambuccian
Diagnostic Cytopathology.2012; 40(7): 639. CrossRef

Original Articles

Serochemical and Histopathological Observations on the Effect of Malotilate in Chronic Liver Injury Induced by Carbon Tetrachloride with or without Ethanol.: Hyoung Chun Kim, Eon Sub Park, Jae Hyung Yoo, Kye Yong Song; Korean J Pathol. 1989;23(2):223-234.

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Abstract PDF: An experimental studies were carried out to observe the protective effects of malotilate, a new antihepatotoxic agent, on the chronic hepatic injury induced by CCl4 with or without ethanol. The rats used weighed about 200g were divided into 2 groups, 4 weeks & 8 weeks. Each group was given by orally with malotilate, 100 mg/kg, once a day, and was injected by subcutaneously with CCl4 1.5 mg/kg in a mixture with olive oil twice a week. Aqueous ethanol (20%) was administered in drinking water daily. The serochemical and histopathological studies were carried out in each experimental group. The results were as follows: 1. The chronic liver injuries induced by CCl4 with or without ethanol were significantly ameliorated by normalize serum values GOT, GPT. Alkaline phosphatase, Cholesterol, HDL-Cholesterol, and gamma glutamyl transpeptidase. 2. In Group of 4 weeks, malotilate manifested protective effects by significant inhibition of fatty changes, spotty necrosis and fibrosis in CCl4-intoxicated liver with or without additional ethanol. 3. In group of 8 weeks, malotilate significantly imoproved fatty changes, fibrogenic activity in the group administered with CCl4, followed by ethanol.

Cystandenoma and Primary Cystadenocarcinoma of the Liver.: Kyoung Ho Kim, Chan Il Park; Korean J Pathol. 1989;23(2):263-268.

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Abstract PDF: Primary cystic neoplasia of the liver is rare. We report a cystadenoma with mesenchymal stroma (CMS) and a cystadenocarcinoma, and make a review of literature with particular reference to their histogenesis. The CMS has many similarities to the ovarian mucinous cystadenoma; occurring almost exlusively in female, being lined by mucus-secreting epithelial cells, and containing dense ovarian-like stroma. These features suggest that CMS may arise from the ectopic ovarian tissue within the liver. Cystadenocarcinoma may have its origin in CMS or cystadenoma without mesenchymal stroma of CMS. Cholangiocarcinoma arising from the congenital hepatic cysts can be differentiated only when it contains benign epithelia.

Histologic Pattern of Alcoholic Liver Disease in Korea.: Chan Il Park, Ho Guen Kim, So Young Jin, Mi Kyung Lee, Yoo Bock Lee; Korean J Pathol. 1989;23(3):292-304.

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Abstract PDF: To elucidate the histologic pattern of alcoholic liver disease (ALD) in Korea, liver biopsies from 173 chronic alcoholics with clinical liver diseases were classified according to the pathologic parameters. One hundred and seventeen cases, the sum of 91 of 116 serum HBsAg negative and 26 of 57 HBsAg positive patients, had the histologic evidence of ALD. Fatty change(23.9%), alcoholic fibrosis (AF)(23.1%) and cirrhosis (23.1%), comprised the three major ALDs, and only 8.5% of cases fit the criteria of alcoholic hepatitis. Chronic sclerosing hyaline disease (CSHD), chronic active alcoholic hepatitis (CAAH) and AF, where non-cirrhotic fibrosis is the predominant change, comprised 44.5% of ALD. Both features of ALD and HBV liver disease (HBV-LD) were found in 17 cases that included 8 AF and 7 cirrhosis. These 17 patients tended to consume less alcohol than patients with other types of pure ALD except alcoholic heaptitis. Patients with the serum HBsAg positive ALD (37.4years) were about 8 years younger than those with the serum HBsAg negative ALD (45.1years). More or less fatty change and foamy degeneration were seen in 77.4% and 31.6% of ALD respectively. Mallory bodies, megamitochondria, iron deposition and perihepatocellular fibrosis were found in 20.5%, 29.9%, 42.7% and 77.8%, respectively. These findings indicate that non-cirrhotic chronic ALD such as CSHD, CAAH and AF are the important histologic patterns of ALD in Korea, and that chronic alcohol consumption and HBV may act synergistically in developing liver disease.

Eosinophilic Liver Abscess in Patients with Gastric Carcinoma.: Soon Won Hong, Ho Guen Kim, Chan Il Park, Sang In Lee; Korean J Pathol. 1993;27(1):27-33.

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Abstract PDF: Sixteen cases of heavy eosinophil infiltration or eosinophilic abscess of the liver in patients with gastric carcinoma were analyzed to draw attention to this interesting combination and to persue the pathogenetic mechanism. Peripheral blood eosinophilia and hepatic granuloma were found in only 5 and 4 cases, respectively. Neither the patients' stool nor the hepatic tissues disclosed any parasitic worms or eggs, although the skin tests for Clonorchis sinensis and Paragonimus westermani were positive in 2 cases. Among stomach carcinomas, early gastric cancer tended to have more eosinophils than advanced carcinoma, but was less frequently associated with the infiltration of mast cells. In the regional lymph nodes, there was no infiltration of eosinophils even in the presence of tumor metastasis. In the liver, none of the 16 cases had metastatic gastric carcinoma and mast cells were found in only 2 cases. The results suggest that heavy hepatic infiltration of eosinophils in gastric carcinoma patients is not of the parasitic or allergic cause, but of certain eosinophil chemotactic factor which may gain access to accumulate in the liver following released from the gastric carcinoma and transfered through the portal vein.

Case Report

Epithelioid Hemangioendothelioma of Liver: A case report.: Yoo Jin Kim, Jae Hwa Lee, Bang Hur, Man Ha Hur; Korean J Pathol. 1995;29(3):378-384.

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Abstract PDF: Epithelioid hemangioendothelioma of liver is a very rare tumor of vascular origin, the most peculiar feature of which is that it is composed of endothelial cells closely resembling epithelial cells. We present a primary epithelioid hemangioendothelioma of liver in a 40-year-old male. This tumor was composed of an ill-defined yellowish white, 7 x 4cm sized, firm, solid mass and small satellite nodules in the right lobe of liver. Microscopically, two types of tumor cells-dendritic and epithelioid-were identified. The neoplastic cells infiltrated into sinusoids and intrahepatic veins. The background of tumor showed marked sclerotic change and focal proliferation of bile ductules. Confirmation of the endothelial origin of these cells was provided by positive immunoperoxidase staining for factor VIII-related antigen, and by electron mi-croscopic demonstration of Weibel-Palade body. This is the first case of epithelioid heman- gioendothelioma of liver documented in Korea. We report this case in view of its scarcity and distinctive morphologic features that allow differentiation from sclerosing carcinoma and angiosarcoma.

Original Article

Pathological Analysis of 62 Liver Biopsy Cases with Hepatocellular Cholestasis: Drug and Toxin Induced Liver Injury.: Min Sun Cho, Young Nyun Park, Myeong Jin Kim, Kwang Jo Chae, Chanil Park; Korean J Pathol. 2001;35(2):123-128.

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Abstract PDF: BACKGROUND
Hepatocellular cholestasis denotes the alteration of bile secretion by hepatocytes. The causes, degree of hepatocyte injury and concomitant bile duct loss are considered to influence the clinical course.
METHODS
The causes and pathological features of hepatocellular cholestasis were analyzed in 62 cases of liver biopsies; and the causes of primary biliary cirrhosis, primary sclerosing cholangitis, and biliary obstruction were not included.
RESULTS
The mean age of the patients was 42.2 years, and the ratio of male to female was 1.8:1. Fifty-eight cases (94%) showed cholestatic hepatitis, and 4 cases (6%) showed pure cholestasis without hepatitis activity. The majority of the cases (52 cases, 84%), including 19 cases of herbal medicine, was related to drugs. Loss of bile duct was found in 12 cases (19%), which were all cases of chronic cholestasis. All of them had drug histories, including 9 cases of herbal medicine. Clinical follow-up was performed in 9 out of the 12 cases with bile duct loss, and all of them showed elevated total bilirubin and/or alkaline phosphatase levels for more than 6 months.
CONCLUSION
Drugs are the major cause of hepatocellular cholestatic hepatitis/cholestasis; and information about drugs, including herbal medicines, should be considered for proper evaluation of liver biopsy with hepatocellular cholestasis. Bile duct loss should be evaluated in the cases of chronic hepatocellular cholestasis, especially in drug induced cases.

Case Report

Fine Needle Aspiration Cytology of Osteoclast-like Giant Cell Tumor of the Liver: A Case Report .: Chan Sik Park, Ji Eun Kim, Mee Soo Chang; J Pathol Transl Med. 1999;10(1):79-84.

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Abstract PDF: Osteoclast-like giant cell tumor of the liver is an extremely rare malignancy with poor prognosis. To our knowledge, 5 cases have been reported in English literatures, but there was no report about fine needle aspiration cytologic(FNAC) features. We experienced a case of osteoclast-like giant cell tumor of the liver obtained by computed tomography(CT)-guided FNAC and needle biopsy. The cytologic findings mimicked giant cell tumor of the bone. A large hepatic mass of the left lobe with abdominal wall invasion was found by CT in a 46-year-old female complaining of epigastric pain. The FNAC showed moderately cellular smears consisting of osteoclast-like giant cells and mononuclear cells, which were individually scattered or intermingled in clusters. The osteoclast-like giant cells had abundant cytoplasms and multiple small round nuclei with fine chromatin and distinct nucleoli. The mononuclear cells had moderate amount of cytoplasm and relatively bland-looking oval nuclei with single small nucleoli. All of the cytologic features recapitulated the histologic findings of bland-looking osteoclast-like multinucleated giant cells evenly dispersed throughout the background of mononuclear cell. The immunohistochemical study showed positive reaction for CD68 and vimentin, but negative for cytokeratin in both osteoclast-like giant cells and mononuclear cells.

Original Article

A Clinicopathological Study of Posttransplant Liver Biopsy.: Na Rae Kim, Dae Su Kim, Young Lyun Oh, Mi Kyung Kim, Young Hyeh Ko; Korean J Pathol. 1999;33(3):169-178.

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Abstract PDF: Liver biopsies are used routinely in the assessment of graft dysfunction following liver transplantation and generally considered to be the most reliable method for the diagnosis of posttransplant complications with overlapping clinical and laboratory findings. To investigate posttransplant complications causing graft dysfunction and usefulness of liver biopsy, we analysed clinicopathologic features of 65 posttransplant liver biopsies, 2 autopsies and an explanted liver, taken from 20 patients. The frequencies of posttransplant complications were acute cellular rejection in 9 patients (45%), postoperative infection in 11 patients (55%), of which cytomegalovirus (CMV) infection and systemic invasive aspergillosis with candidiasis occured in 10 patients (50%) and 1 patient (5%), respectively. Remainders were hepatic arterial thrombosis in two (10%), primary graft dysfunction due to fatty donor liver in one (5%), and posttransplant lymphoproliferative disorder (PTLD) in two (10%). There were no chronic rejection or recurrent disease. Postoperative mortality was 25%. Histologic grade by Banff schema was well correlated with clinical parameters associated with unfavorable short term prognosis. CMV infection was associated with acute cellular rejection in 6 out of 10 patients (60%). Immunohistochemical staining for CMV was more sensitive method than CMV in situ hybridization or histologic detection of viral inclusion on tissue section. It was unique that one case of PTLD developed under the circumstances of the lowest dosage of immunosuppression and took grave outcome. Based on these results, we concluded that clinicopathologic correlation with integration of all the clinical and laboratory findings is necessary in the interpretation of accurate and early diagnosis of posttransplant liver biopsies. The interrelationship between chronic rejection and CMV infection as well as pathogenetic factors of PTLD remains to be clarified through further ongoing observation.

Case Reports

Ectopic Paragonimiasis Presented as Multiple Colonic and Liver Masses.: Hye Sung Kim, Young Soo Lee, Yun Kyung Kang, Hye Kyung Lee, Jun Hee Kim, Hyuk Sang Lee; Korean J Pathol. 1997;31(4):357-360.

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Abstract PDF: Ectopic paragonimiasis has been diagnosed in many organs such as the mesentery, ovary, pleura, central nervous system, subcutis and very rarely in the liver. However, simultaneous involvement of the colon and liver, which mimics colonic cancer with liver metastasis, is quite unusual, and to our knowledge has never been reported. Our case is a 63 year old woman who visited our hospital because of upper abdominal pain. Radiologically, space occupying lesions were detected in the transverse colon, mesocolon and left hepatic lobe. After the radical presection, they were proved to be an ectopic paragonimiasis forming multiple cavitary parasitic granulomas with Charcot-Leyden crystals and degenerating eggs.

Congenital Neuroblastoma of the Adrenal with Metastasis to Liver, Contralateral Adrenal and Pituitary: Report of an autopsy case.: Na Hye Myong, Sang Yong Song, Je G Chi; Korean J Pathol. 1993;27(2):169-174.

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Abstract PDF: Neoplasms presenting at birth or within the first month of life are defined as congenital tumors. The principal components of this congenital tumors are neuroblastoma, leukemia, brain tumors and sarcomas. The neuroblastoma is the most common accounting for 15~50% of all tumors in this group. It most often presents with an abdominal mass due to adrenal-retroperitoneal primary or hepatomegaly resulting from extensive metastasis. Most often the primary site is adrenal but other loci include the retroperitoneum, mediastinum, pelvis, etc. This 2-day-old female presented with hepatomegaly and a left adrenal mass at birth, first detected by ultrasonography. On the first day, she suffered from hematemesis and bradycardia. She died on the second day. Postmortem examination revealed massive metastatic tumor nodules in the liver and a well-demarcated round mass, 4 cm, in the left adrenal, with necrosis and hemorrhage. Microscopic findings revealed largely undifferentiated neuroblastoma with focal neuronal differentiation and areas of necrosis and calcification in the background of fine fibrovascular stroma. Other metastatic foci were detected in the right adrenal and pituitary gland.

Original Article

Inhibitory Effect of Tetrandrine on Extracellular Matrix Deposition in Rat Hepatic Fibrosis.: Won Young Choi, Hyo Jeong Chae, Sun Kyung Lee; Korean J Pathol. 1999;33(5):319-325.

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Abstract PDF: No effective therapy has yet developed for liver fibrosis/cirrhosis by directly inhibiting the accumulation of extracellular matrix. This study was undertaken to determine the effect of tetrandrine in rat model of liver fibrosis induced by carborn tetrachloride (CCl4) administration intraorally. Tetrandrine, a calcium channel blocker, is anti-inflammatory constituent of the families Menispermaceae and Ranunculaceae, which have been used as folk remedies in China. Repeated administration of CCl4 for 14 weeks to rats induced liver fibrosis with steatosis. Rats were killed after 4, 8 or 14 weeks of treatment with CCl4, CCl4 tetrandrine (30 mg/kg) or CCl4 tetrandrine (50 mg/kg). The histopathological findings of liver were observed semi-quantitatively by light microscopy and volume percentage of the collagen deposition was determined by image analyzer. Tetrandrine inhibited collagen deposition induced by CCl4 administration, as shown by less severe steatosis and fibrosis and significantly decreased volume percentage of collagen fibers in CCl4 tetrandrine treated animals compared with CCl4 only group. Thus, the administration of tetrandrine holds great promise for treating subjects with liver fibrosis/cirrhosis as a result of chronic hepatic injury.

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