Undiagnosed Hepatocellular Carcinoma Presenting as Nasal Metastases

Figure 2

Histopathological studies. (a) H&E staining showing sheets and nests of cells divided by delicate capillaries network. Cytologically, the cells are polygonal with pink cytoplasm and markedly pleomorphic nuclei. (b) Immunohistochemistry: the tumor cells are strongly and diffusely positive with HepPar1, arginase, CD10, and pancytokeratin. Stains with TTF-1, S100, Melan-A, CK7, CK20, P63, synaptophysin, Vimentin, inhibin, PSA, RCC, CK19, and alpha-1-fetoprotein. (c) Liver biopsy reveals large atypical hepatocytes with somehow papillaroid configuration and exhibits marked nuclear pleomorphism and nuclear pseudo-inclusion.

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