Published October 31, 2024 | Version http://impactfactor.org/PDF/IJPCR/16/IJPCR,Vol16,Issue10,Article141.pdf
Journal article Open

Spectrum of Primary Tumor Sites of Liver Metastatic Deposits Established on Histopathological Findings

  • 1. Assistant professor, Pathology Department, NIMS Medical College Jaipur
  • 2. Senior Resident, Pathology Department, NIMS Medical College Jaipur
  • 3. Resident, Orthopaedics Department, NIMS Medical College, Jaipur

Description

Aim: descriptive analysis of the histomorphological spectrum of metastatic deposits in liver from different primaries and categorize them according to age, sex, morphology and immunohistochemical interpretations. Materials and Methods: Our study was carried out in the Pathology department of NIMS Medical College, Jaipur on 94 patients who were suspected for liver metastasis clinically and underwent biopsy for histopathological findings over a time duration of 3 years. Complete clinical history of the included patients was taken along with their radiological investigations, serum markers, cytological findings and treatment history. Results: In this study maximum number of cases of liver metastasis were Gastrointestinal in origin (47 cases: 50%) including colorectal, gall bladder, pancreas, pancreatobiliary and gastric origin. Out of these most common sites for liver metastasis was observed from gall bladder; reported as adenocarcinomas (18 cases; 19.15%) confirmed on IHC findings of keratin 7 and 20 and keratin19. Amongst the 10 cases of pancreatic origin metastasis (CEA and CA19.9), predominant cases (9 out of 10) were pancreatic adenocarcinoma and one case of neuroendocrine tumor of pancreas was reported.  10 cases were reported as pancreatobiliary metastasis on the basis of IHC findings out of which 6 were confirmed to be adenocarcinomas of pancreatobiliary origin one case of extrahepatic cholangiocarcinoma and 2 cases of periampullary origin were found. Stomach primaries (4 cases) were mostly adenocarcinomas which deposited metastasis in liver while one case of gastrointestinal stromal tumor was observed with IHC confirmation. Second most common metastasis was from Lung primaries (23 cases; 24.5%). Conclusion: Incorporating clinical history, radiological findings, and IHC is crucial to differentiate primary liver tumors from metastases, ensuring accurate diagnosis and appropriate treatment planning.

 

 

Abstract (English)

Aim: descriptive analysis of the histomorphological spectrum of metastatic deposits in liver from different primaries and categorize them according to age, sex, morphology and immunohistochemical interpretations. Materials and Methods: Our study was carried out in the Pathology department of NIMS Medical College, Jaipur on 94 patients who were suspected for liver metastasis clinically and underwent biopsy for histopathological findings over a time duration of 3 years. Complete clinical history of the included patients was taken along with their radiological investigations, serum markers, cytological findings and treatment history. Results: In this study maximum number of cases of liver metastasis were Gastrointestinal in origin (47 cases: 50%) including colorectal, gall bladder, pancreas, pancreatobiliary and gastric origin. Out of these most common sites for liver metastasis was observed from gall bladder; reported as adenocarcinomas (18 cases; 19.15%) confirmed on IHC findings of keratin 7 and 20 and keratin19. Amongst the 10 cases of pancreatic origin metastasis (CEA and CA19.9), predominant cases (9 out of 10) were pancreatic adenocarcinoma and one case of neuroendocrine tumor of pancreas was reported.  10 cases were reported as pancreatobiliary metastasis on the basis of IHC findings out of which 6 were confirmed to be adenocarcinomas of pancreatobiliary origin one case of extrahepatic cholangiocarcinoma and 2 cases of periampullary origin were found. Stomach primaries (4 cases) were mostly adenocarcinomas which deposited metastasis in liver while one case of gastrointestinal stromal tumor was observed with IHC confirmation. Second most common metastasis was from Lung primaries (23 cases; 24.5%). Conclusion: Incorporating clinical history, radiological findings, and IHC is crucial to differentiate primary liver tumors from metastases, ensuring accurate diagnosis and appropriate treatment planning.

 

 

Files

IJPCR,Vol16,Issue10,Article141.pdf

Files (1.1 MB)

Name Size Download all
md5:6cba75f30c36fab4a841755ec20c3bc1
1.1 MB Preview Download

Additional details

Dates

Accepted
2024-09-26

References

  • 1. Griscom JT, Wolf PS. Liver Metastasis. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi. nlm.nih.gov/books/NBK553118/ 2. Weiss L. Comments on hematogenous metastatic patterns in humans as revealed by autopsy. Clin Exp Metastasis. 1992 May; 10(3):191- 9. 3. De Ridder J, de Wilt JH, Simmer F, Overbeek L, Lemmens V, Nagtegaal I. Incidence and origin of histologically confirmed liver metastases: an explorative case-study of 23,154 patients. Oncotarget. 2016 Aug 23; 7(34):55368- 55376. 4. De Ridder J, de Wilt JH, Simmer F, Overbeek L, Lemmens V, Nagtegaal I. Incidence and origin of histologically confirmed liver metastases: an explorative case-study of 23,154 patients. Oncotarget. 2016 Aug 23; 7(34):55368- 55376. doi: 10.18632/oncotarget.10552. PMID: 27421135; PMCID: PMC5342423. 5. Fleming M, Ravula S, Tatishchev SF, Wang HL. Colorectal carcinoma: pathologic aspects. J Gastrointest Oncol 2012; 3:153-173 6. Van der Geest LGM, Lam-Boer J, Koopman M, et al. Nationwide trends in incidence, treatment and survival of colorectal cancer patients with synchronous metastases. Clin Exp Metastasis 2015; 32:457-65. 10.1007/s10585- 015-9719-0 7. Kow AWC. Hepatic metastasis from colorectal cancer. J Gastrointest Oncol. 2019; 10(6): 127 4-1298. doi:10.21037/jgo.2019.08.06. 8. Zhang, Yi-Jun et al.SATB2 is a Promising Biomarker for Identifying a Colorectal Origin for Liver Metastatic Adenocarcinomas. eBioMedicine, Volume 28, 62 – 69. 9. Cai YL, Lin YX, Jiang LS, Ye H, Li FY, Cheng NS. A novel nomogram predicting distant metastasis in T1 and T2 gallbladder cancer: a SEER-based study. Int J Med Sci. (2020) 17(12):1704–12. 10.7150/ijms.47073 10. Yang Y, Tu Z, Ye C, Cai H, Yang S, Chen X, et al. Site-specific metastases of gallbladder adenocarcinoma and their prognostic value for survival: a SEER-based study. BMC Surg. (2021) 21(1):59. 10.1186/s12893-021-01068- 8. 11. Rindi G, Arnold R, Bosman FT, Capella C, Klimstra DS, Klöppel G, et al. Nomenclature and classification of neuroendocrine neoplasms of the digestive system. In: Bosman FT, Carneiro F, Hruban RH, Theise ND, eds. WHO classification of tumours of the digestive system. 4th ed. Lyon: World Health Organization, 2010:13-14. 12. Dasari A, Shen C, Halperin D, Zhao B, Zhou S, Xu Y, et al. Trends in the incidence, prevalence, and survival outcomes in patients with neuroendocrine tumors in the United States. JAMA Oncol 2017; 3:1335-1342. 13. Prosser JM, Dusenbery D. Histocytologic diagnosis of neuroendocrine tumors in the liver: a retrospective study of 23 cases. Diagn Cytopathol. 1997 May; 16(5):383-91. 14. Wang, M.; Abi-Raad, R.; Baldassarri, R.; Adeniran, A.J.; Cai, G. Expression of insulinoma-associated protein 1 in non–small cell lung cancers: A diagnostic pitfall for neuroendocrine tumors. Hum. Pathol. 2021, 115, 104– 111. 15. Kaufmann O, Dietel M. Expression of thyroid transcription factor-1 in pulmonary and extrapulmonary small cell carcinomas and other neuroendocrine carcinomas of various primary sites. Histopathology. 2000; 36:415–420 16. Juhlin, C.C.; Zedenius, J.; Höög, A. Clinical Routine Application of the Second-generation Neuroendocrine Markers ISL1, INSM1, and Secretagogin in Neuroendocrine Neoplasia: Staining Outcomes and Potential Clues for Determining Tumor Origin. Endocr. Pathol. 2020, 31, 401–410. 17. Clark AM, Ma B, Taylor DL, Griffith L, Wells A. Liver metastases: Microenvironments and ex-vivo models. Exp Biol Med (Maywood) (2016) 241(15):1639–52. 18. Kagohashi, K., Satoh, H., Ishikawa, H., Ohtsuka, M., & Sekizawa, K. (2003). Liver Metastasis at the Time of Initial Diagnosis of Lung Cancer. Medical Oncology, 20(1), 25–28. 19. Wu B, Wei S, Tian J, Song X, Hu P, Cui Y. [Comparison of the Survival Time in the Nonsmall Cell Lung Cancer Patients with Different Organ Metastasis]. Zhongguo Fei Ai Za Zhi (2019) 22(2):105–10. 20. Kagohashi, K., Satoh, H., Ishikawa, H., Ohtsuka, M., & Sekizawa, K. (2003). Liver Metastasis at the Time of Initial Diagnosis of Lung Cancer. Medical Oncology, 20(1), 25–28. 21. Chaudhry UI, DeMatteo RP. Advances in the surgical management of gastrointestinal stromal tumor. Adv Surg 2011; 45: 197–209. 22. Miettinen M, Lasota J. Gastrointestinal stromal tumors–definition, clinical, histological, immunohistochemical, and molecular genetic features and differential diagnosis. Virchows Arch. 2001; 438:1–12. 23. Shi YN, Li Y, Wang LP, et al. Gastrointestinal stromal tumor (GIST) with liver metastases: An 18-year experience from the GIST cooperation group in North China. Medicine (Baltimore). 2017; 96(46):e8240.