[Focal fatty change (FFC) imitating liver malignancy. Own cases and review of literature]. / Ogniskowe stluszczenie watroby (focal fatty change--FFC) pod postacia guzów imitujacych chorobe nowotworowa. Spostrzezenia wlasne i przeglad literatury.

UNLABELLED: Focal fatty change (FFC) may occur in the form of a single or numerous nodules of different size, located in the liver with otherwise normal structure. These changes, especially when they are large and single, pose an important diagnostic problem as their clinical and radiological picture may imitate malignancy. In the paper we report two cases of large hepatic tumors (12 cm and 8 cm) in patients, who had no factors predisposing to fatty liver changes (such as alcohol abuse, drugs, obesity, hormone disturbances, impaired blood flow through the liver or metabolic disturbances). In microscopic examinations the nodules were diagnosed as foci of large-droplet hepatocellular steatosis. Apart from these changes the liver was normal. CONCLUSION: FFC belongs to a group of pseudotumor changes. It occurs in rare cases and should be distinguished from diffuse changes observed frequently. In the differential diagnosis, the following must also be considered: primary hepatocellular tumors with fatty change, FNH with fatty change, mesenchymal tumors containing adipose tissue, fatty macro-regenerative nodule, adipocytic pseudotumor of the Glisson's capsule.

[Comparison of CD15, galectin-3 and HBME-1 expression in follicular thyroid neoplasms]. / Porówmanie ekspresji CD15, galektyny-3 i HBME-1 w nowotworach pecherzykowych tarczycy.

INTRODUCTION: Estimation of malignancy in thyroid follicular neoplasms is a common diagnostic problem, thus revealing of differences in expression of some antigens in both benign and malignant lesions seems to be essential. The aim of this study is to evaluate the immunohistochemical expression of CD15, galectin-3 and HBME-1 in follicular adenomas and carcinomas. MATERIAL AND METHODS: Samples of 38 follicular adenomas (23 "classical", 5 with intracapsular invasion, 10 oncocytic) and 15 follicular carcinomas (9 "classic", 6 oncocytic) were stained immunohistochemically with anti-CD15, galectin-3 and HBME-1. RESULTS: In the whole group we found statistically significant differences in CD15 expression between follicular adenomas and carcinomas. "Classic" follicular carcinomas (without oncocytic tumors) showed stronger CD15 and HBME- 1 expression than "classic" adenomas. Adenomas with intracapsular invasion differed from "classic" adenomas only in HBME-1 expression. In oncocytic tumors the expression of examined antigens was similar. CONCLUSIONS: 1. In the group of nonoxyphilic tumors positive reaction with HBME-1 was more common in adenomas with intracapsular invasion and carcinomas, but positive reaction with anti-CD15--only in carcinomas. We suggest that reactivity with these antibodies could mark malignancy. 2. Oncocytic tumors had similar expression of CD15 and HBME-1 and galectin-3.

[Carcinoma hepatoides of the stomach --case report and literature review]. / Rak zoladka z róznicowaniem watrobowokomórkowym (carcinoma hepatoides)--opis przypadku i przeglad literatury.

UNLABELLED: Hepatoid differentiation in neoplastic tumors occurs not only in primary hepatic carcinoma but also in other malignant tumors, especially carcinomas. Stomach is the most frequent site of such tumors. Usually, at the time of diagnosis liver metastases are found and it is difficult to establish what was the primary site of hepatoid-like carcinoma. CASE REPORT: 83-year-old man was admitted to the hospital due to upper gastrointestinal haemorrhage. Beside weight loss (11 kg during the period of 3 months) he did not complain of any symptoms. Urgent gastroscopy revealed in the middle portion of the gastric corpus two ulcers 12 and 3 mm in diameters and just above them polyp 1.5 cm in diameter. The other parts of gastrointestinal tract were normal. Neoplastic infiltration of the whole thickness of the gastric wall was found in the histopathologic examination of the specimens taken from all these lesions. The lesion consisted of the hepatocyte-like cells with the droplets of bile visible among them. Morphological examination and immunohistochemical results (CKMNF+, CKhepatocyte+, Vimentin and CD68 negative) were consistent with very rare hepatoid type of gastric cancer--carcinoma hepatoides. The following investigations (USG, CT) showed tumor in the II, III and IV segments of the liver and thromboses in the left branch of vena porta and middle hepatic vena. The serum level of AFP was high (5837 ng/l). The possibility of gastric infiltration by primary hepatic tumor and primary gastric hepatoides carcinoma were considered in the differential diagnosis. CONCLUSION: Morphological characteristics of primary hepatic carcinoma may be identical with primary gastric hepatoides carcinoma. When the biopsy specimens are very small even immunohistochemical examination does not allow to establish the diagnosis.