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Canadian Journal of Gastroenterology
Volume 10, Issue 1, Pages 12-16

Mucin in Primary Liver Carcinomas: Combined Hepatocellular-Cholangiocarcinoma or Variant Hepatocellular Carcinoma

Shigeru Hirota,1,2 Minoru Nomoto,1,2 Sadahiro Hosobe,1,2 Yutaka Aoyagi,1,2 and Hitoshi Asakura1,2

1Departments of Gastroenterology and Pathology, Akita Red Cross Hospital, Nakadouri Akita City, Japan
2The Third Department of Internal Medicine, Niigata University, Niigata City, Japan

Received 22 March 1995; Revised 30 June 1995

Copyright © 1996 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


OBJECTIVE: To investigate whether the presence of mucin defines a combined hepatocellular-cholangiocarcinoma or merely a variant of usual hepatocellular carcinoma (HCC).

METHODS: From 1979-92, 124 cases of usual HCC were studied at Niigata University Hospital, Niigata City, Japan, and several affiliated hospitals. Histological diagnoses were determined according to World Health Organization (WHO) criteria. Hematoxylin and eosin stain, periodic acid-Schiff (PAS) stain, PAS stain after diastase digestion (D-PAS) and silver stain tests were performed. Cases containing D-PAS-positive substances were also stained by Alcian blue (AB) stain, high iron diamine (HID) stain and concanavaline A paradox-3 type (ConA3) stain. The classification of mucin was determined by AB, HID and ConA3 stains.

RESULTS: Mucin was recognized in the area of HCC by mucin stains in 25 of 124 cases. Two forms of mucin existence were classified: extracellular and intracellular. Mucins were classified by histochemical stains into three types: sulfomucin, sialomucin and neutral mucin.

CONCLUSIONS: According to the WHO histological classification of primary carcinoma of the liver, mucin existence is characteristic of intrahepatic cholangiocarcinoma. But if mucin exists in morphologically usual HCC, it is better to diagnose it as a variant of HCC (with mucin) rather than as a combined hepatocellular-cholangiocarcinoma.