A Study of Trucut Biopsies of Hepatic Lesions with Special Reference to Immunohistochemistry and Special Stain.

Veenaa, N N (2013) A Study of Trucut Biopsies of Hepatic Lesions with Special Reference to Immunohistochemistry and Special Stain. Masters thesis, Coimbatore Medical College, Coimbatore.

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Abstract

Hepatocellular Carcinoma Is One Of The Commonest Malignancies That Account To About Half A Million Deaths Yearly. It Ranks In The Fifth Place Globally. 80% Of These Cases Are Seen In The Asian- Pacific Region. Less Than 20% Of Hepatocellular Carcinomas Get The Appropriate Treatment As Surgical Resection As Therapy When They Are Diagnosed. It Is Purely Due To The Advanced Stage Of The Disease At The Time Of Diagnosis. The Risk Factors Of This Cancer Are Well Defined. Worldwide, About 80% Of Cases Are Due To Cirrhotic Livers. In Asia And Africa It Is Hepatitis B Virus Infection; As It Is An Oncogenic Virus, It Can Cause Cancer In The Absence Of Cirrhosis. In Countries Like Europe, Japan And United States, The Bulk Of The Infection Is Due To Hepatitis C Than B Because Of The Vaccination Given For Newborns. Immunohistochemistry May Help Distinguishing Hepatocellular Carcinoma And Its Mimics. The Challenges Are Attributed As Follows: 1) Hepatic Stem Cell Lineage Can Give Rise To Any Neoplasm. 2) Nodular Lesions Of Liver. 3) Metastatic Tumours Of Liver. 4) Serum Alpha Fetoprotein Has Its Own Limitations. The Pivotal Role Of Immunohistochemistry Is In Differentiating Benign Nodular Lesions From Reactive Conditions, Benign Nodular Lesions From Well Differentiated Hepatocellular Carcinoma, Cholangiocarcinoma From Metastasis And Poorly Differentiated Tumours Of Hepatic Origin And To Ascertain The Origin Of The Tumour Whether Primary Or Secondary. Alpha Fetoprotein Is The Protein That Determines The Histogenesis Of The Tumour From The Liver. Bile Canaliculi Are Stained By P-Cea And Cd10. Hep Par 1 Is A Hepatocyte Marker. Cam 5.2, Cytokeratin 8 And Cytokeratin 18 Stain Mature Hepatocytes And Nodules. Cytokeratin 7, Cytokeratin 19, Cytokeratin 20 And Cytokeratin Ae1/Ae3 Are Absent. Sinusoids Take Up Cd34. Alpha Fetoprotein, P-Cea, Cd10 And Cd34 Are The Primary Panel Markers To Tell That The Malignant Nodule Is Hepatocyte In Origin. If Histogenesis Is Questioned, Then Hep Par 1 And Cytokeratin Come Into Play. The Purpose Of This Study Is To Examine The Usefulness Of Immunohistochemistry In Differentiating Primary From Metastatic Neoplasms Of Liver And To Evaluate The Role Of Reticulin Stain To Differentiate Benign From Malignant Lesions Of Liver.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Trucut Biopsies ; Hepatic Lesions ; Special Reference ; Immunohistochemistry ; Special Stain.
Subjects: MEDICAL > Pathology
Depositing User: Subramani R
Date Deposited: 29 Jun 2017 07:26
Last Modified: 29 Jun 2017 07:26
URI: http://repository-tnmgrmu.ac.in/id/eprint/613

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