Diffuse glutamine synthetase overexpression restricted to areas of peliosis in a β-catenin-activated hepatocellular adenoma: a potential pitfall in glutamine synthetase interpretation. Academic Article Case Study uri icon

start page

  • 241

end page

  • 245

abstract

  • Hepatocellular adenomas have recently been classified into four subtypes based on molecular findings: hepatocyte nuclear factor 1α (HNF1α) inactivated, inflammatory/telangiectatic, β-catenin activated, and unclassifiable. β-catenin-activated adenomas have the potential for malignant transformation and are thus important to recognize. Diffuse glutamine synthetase immunohistochemical positivity has been shown to be a reliable surrogate marker for β-catenin activation, though variations in staining patterns may be difficult to interpret. We report a case of a peliotic adenoma that was morphologically consistent with a β-catenin wild-type hepatocellular adenoma but harbored a β-catenin mutation by molecular analysis. The tumor lacked nuclear β-catenin positivity and demonstrated a hitherto undescribed pattern of glutamine synthetase overexpression restricted to areas of peliosis with mostly negative staining in non-peliotic areas. This pattern was initially interpreted as physiologic and may represent a potential pitfall in glutamine synthetase interpretation.

date/time value

  • August 2014

Digital Object Identifier (DOI)

  • 10.1007/s00428-014-1620-8

PubMed Identifier

  • 24997695

volume

  • 465

number

  • 2

keywords

  • Adenoma, Liver Cell
  • Comorbidity
  • Female
  • Gene Expression Regulation, Neoplastic
  • Glutamate-Ammonia Ligase
  • Hepatectomy
  • Humans
  • Liver
  • Liver Neoplasms
  • Middle Aged
  • Mutation
  • Peliosis Hepatis
  • Tumor Markers, Biological
  • Up-Regulation
  • beta Catenin