chromophobe hepatocellular carcinoma with abrupt anaplasia

Hepatocellular carcinomas exhibit heterogeneous morphologies by routine light microscopy. Although some morphologies represent insignificant variations in growth patterns, others may represent unrecognized subtypes of hepatocellular carcinoma.

Identification of these subtypes could lead to separation of hepatocellular carcinomas into discrete groups with unique underlying genetic changes, prognosis, or therapeutic responses.

This subtype was characterized by a unique and consistent set of histological features: smooth chromophobic cytoplasm, abrupt focal nuclear anaplasia (small clusters of tumor cells with marked nuclear anaplasia in a background of tumor cells with bland nuclear cytology), and scattered microscopic pseudocysts-we designate this variant as ’chromophobe hepatocellular carcinoma with abrupt anaplasia’.

Interestingly, at the molecular level, this variant is strongly associated with the alternative lengthening of telomere (ALT) phenotype by telomere FISH.

ALT is a telomerase-independent mechanism of telomere maintenance and is found in approximately 8% of unselected hepatocellular carcinomas. In contrast, 92% of the cases of chromophobe hepatocellular carcinoma with abrupt anaplasia were ALT-positive.

Chromophobe hepatocellular carcinoma with abrupt anaplasia represents a subtype of hepatocellular carcinoma with unique morphological and molecular features.

Reference

 Chromophobe hepatocellular carcinoma with abrupt anaplasia: a proposal for a new subtype of hepatocellular carcinoma with unique morphological and molecular features. Wood LD, Heaphy CM, Daniel HD, Naini BV, Lassman CR, Arroyo MR, Kamel IR, Cosgrove DP, Boitnott JK, Meeker AK, Torbenson MS. Mod Pathol. 2013 May 3. doi : 10.1038/modpathol.2013.68 PMID: 23640129