Updates in the diagnosis of combined hepatocellular-cholangiocarcinoma

Hum Pathol. 2020 Feb:96:48-55. doi: 10.1016/j.humpath.2019.11.001. Epub 2020 Jan 10.

Abstract

Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a rare primary liver carcinoma showing variable degrees of differentiation toward hepatocellular and cholangiocellular carcinoma. Its great heterogeneity in term of morphology, immunophenotype, molecular, radiological and clinical features represents a challenge still to overcome. The multidisciplinary 2018 International Consensus on the nomenclature of cHCC-CCA allowed to define key issues of this entity. Here we review the historical controversies of cHCC-CCA, resume the key elements of the 2018 consensus, now incorporated in the 2019 WHO classification, and propose a short survival guide to help surgical pathologists facing cHCC-CCA in their routine workup.

Keywords: Cholangiocarcinoma; Cholangiolocarcinoma; Combined hepatocellular-cholangiocarcinoma; Hepatocellular carcinoma; Primary liver carcinoma.

Publication types

  • Review

MeSH terms

  • Biomarkers, Tumor / analysis
  • Biomarkers, Tumor / genetics
  • Biopsy
  • Carcinoma, Hepatocellular / chemistry
  • Carcinoma, Hepatocellular / genetics
  • Carcinoma, Hepatocellular / pathology*
  • Carcinoma, Hepatocellular / therapy
  • Cholangiocarcinoma / chemistry
  • Cholangiocarcinoma / genetics
  • Cholangiocarcinoma / pathology*
  • Cholangiocarcinoma / therapy
  • Humans
  • Immunohistochemistry
  • Liver Neoplasms / chemistry
  • Liver Neoplasms / genetics
  • Liver Neoplasms / pathology*
  • Liver Neoplasms / therapy
  • Molecular Diagnostic Techniques
  • Neoplasms, Complex and Mixed / chemistry
  • Neoplasms, Complex and Mixed / genetics
  • Neoplasms, Complex and Mixed / pathology*
  • Neoplasms, Complex and Mixed / therapy
  • Predictive Value of Tests
  • Prognosis

Substances

  • Biomarkers, Tumor