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    ABSTRACT: In a series of 282 cases of primary carcinoma of the liver in Uganda Africans particular attention was paid to the histology of liver cell and bile duct carcinomas, to differences in their natural history and to results of serological testing for alpha fetoprotein (AFP). Liver cell carcinoma was a tumor of younger males and was commonly associated with cirrhosis. Four main histologic types were distinguished: the hepatic type showed a plate like pattern of growth with a scanty stroma of thin walled sinusoids and cellular characteristics that were often strongly reminiscent of the normal liver; bile secretion was rare, but finely granular glycogen was sometimes seen in the cytoplasm of the tumor cells; the pleomorphic type tended to grow in a solid fashion and was composed of bizarre and multinucleate cells; the adenoid type had a seemingly glandular pattern of ducts and cysts that was due, in most instances, to central breakdown in an otherwise solid growth; the rare clear cell type was heavily laden with glycogen. In nearly half of these tumors there were no metastases present at death, which was often the result of rupture of the liver with massive intraperitoneal hemorrhage. By contrast intrahepatic bile duct carcinoma was a tumor of older people of both sexes and showed no association with cirrhosis. Most cases were well to moderately differentiated mucus secreting adenocarcinomas. Widespread dissemination to many organs was common and death was usually due to carcinomatosis. AFP was detected in 53 of 72 (73.6%) of liver cell carcinomas of all types, but in none of 7 bile duct carcinomas. A plea is made for discarding elaborate histogenetic classifications that do not distinguish clearly between liver cell and bile duct carcinomas. The importance of recognizing the 2 main forms of primary liver cancer in diagnosis, epidemiology and research is emphasized.
    The Journal of Pathology 05/1973; 110(1):37-48. DOI:10.1002/path.1711100105 · 7.43 Impact Factor
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    ABSTRACT: Osteoclast-like giant cell tumors (OCGTs) usually involve the bone and rarely affect the alimentary tract. Within the gastrointestinal tract the liver has been one of the most infrequently reported locations for this neoplasm to occur. In this article we report the occurrence of an OCGT arising in the liver of a 61-year-old woman. The patient presented with abdominal pain and a rapidly enlarging hepatic mass. Magnetic resonance imaging (MRI) indicated a multilocular solid lesion in the right lobe of the liver. A small extrahepatic lobulation at the lateral aspect of the lesion with penetration of the capsule was visible. Local extension into adjacent organs was not evident. Positron emission tomography (PET) did not indicate a tumor in the pancreas or elsewhere in the body. The tumor was removed by performing a formal right hepatic lobectomy. Histologic and immunohistochemical examinations revealed an OCGT. Within 3 months of the hemihepatectomy, widespread intraabdominal and pulmonary metastasis developed and the patient succumbed to her illness shortly thereafter. This report contributes further evidence to the aggressive biological behavior with regard to this rare neoplasm. The absence of metastatic disease indicated when using magnetic resonance imaging and positron emission tomography does not seem to change the overall dismal prognosis of this tumor.
    Journal of Gastrointestinal Surgery 03/2005; 9(2):207-14. DOI:10.1016/j.gassur.2004.07.007 · 2.80 Impact Factor
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    ABSTRACT: A case of dedifferentiated hepatocellular carcinoma with osteoclast-like giant cells resembling those of giant cell tumor of bone is presented. The clinicopathologic findings are described, and the literature concerning this type tumor is reviewed. The tumor differed histologically from a pleomorphic variant of hepatocellular carcinoma in that there were numerous osteoclast-like giant cells with numerous, small, uniform, benign-appearing nuclei. To the knowledge of the authors, there has been only one report of this type of tumor arising in the liver. The tumor contained a separate area of a histologically conventional hepatocellular carcinoma, in addition to the above giant cell areas.
    Cancer 09/1984; 54(5):837-42. DOI:10.1002/1097-0142(19840901)54:5<837::AID-CNCR2820540513>3.0.CO;2-8 · 4.89 Impact Factor