ECP 2017 - Abstract Book

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Results: The patient was a 47-year-old man who was admitted to the
hospital due to intestinal obstruction. Tumour mass 1,6 × 1,1 cm in size
was revealed in the wall of the ileum and surgically removed.
Histologically, cribriform mucous glands, dilated and nondilated ducts
surrounded by the disorderly arrangement of smooth muscles, character-
ized the well-circumscribed submucosal mass. Epithelial component of
tumour was negative for MUC2, stromal component was SMA-positive.
The diagnosis of myoepithelial hamartoma was done.
Conclusion: Myoepithelial hamartoma is usually asymptomatic and
found incidentally. Meanwhile, it should be kept in mind to avoid misdi-
agnosis of malignancy and unwanted radical surgery.
E-PS-08-026
Brunner’s gland hamartoma
B. Binboga Tutug*, F. Özyilmaz, F. Öz Puyan, A. Tardu, Z. Keles
*Trakya Universitesi, Dept. of Pathology, Edirne, Turkey
Objective: Brunner’s gland hamartomas are rarely encountered as
polypoid nodules in the proximal duodenum. The nomenclature of
the Brunner ’s gland lesions in the literature is not well
established. Difference in the meaning of the terms “Brunner’s
gland hyperplasia” “Brunner’s gland hamartoma” and “Brunner’s
gland adenoma” remains uncertain and will be discussed on our
case.
Method: Macroscopically, 6,5x5,5x3,5 cm, yellow-cream colored, lobu-
lated, solid appearing, tumoural mass with microcystic changes was seen
on the duodenal resection. Histopathologically, densely packed lobulated
hyperplastic Brunner’s glands were located on the wall. Fibromuscular
septas, smooth muscle fibers and pancreatic ducts were also present inside
the lesion. Immunohistochemically, the glands were positive for MUC6,
CK19 and CK7 and they showed low proliferative activity.
Results: The final diagnosis was Brunner’s gland hamartoma.
Conclusion: Tumours like Brunner’s gland hamartomas of the duode-
num are rare and difficult to diagnose because of their nonspecific symp-
toms. Brunner’s gland hamartoma should be kept in mind on a duodenal
mass.
E-PS-09-001
Evaluation of liver metastases: An 11-year experience
D. Ozyigit Buyuktalanci*, F. H. Dilek, F. Cakalagaoglu, E. Gun, A. Avci,
O. N. Dilek
*Izmir Katip Celebi University, Pathology, Turkey
Objective: The liver is one of the most common metastatic sites of pri-
mary carcinomas.
Method: In this study, the records of the biopsies, resections and fine
needle aspirations of the liver between 2006 and 2017 were reviewed
retrospectively.
Results: The mean age was 60.2 years, with 53 % males and 47 % females.
In a total of 528 specimens, there were 272 needle core biopsies (NCB), 153
metastasectomies, 53 wedge resections, 23 segmental resections and 27 fine
needle aspirations (FNA). Amongst 437 (82.7 %) cases with metastasis, there
were 384 (87.8 %) malignant epitelial tumours, 11 (2.51 %) mesenchymal
tumours, 6 (1.37 %) malignant melanomas and 36 (8.23 %) neuroendocrine
tumours. Primary neoplasms in the liver were seen in 12 patients. Fifty-two of
the cases were negative for tumours because the surgeons could not reach the
tumoural area. A history of primary carcinoma was present in 294 patients.
The first finding in 7 patients was a mass in the liver and primary carcinoma
diagnosis was obtained after the biopsy. In 16 patients despite all the clinical,
radiological and pathological investigations the site of primary carcinoma
could not be reached while 67 patients without follow-ups were excluded.
Conclusion: The present study demonstrates that, it can be very difficult
to find the primaries of some liver metastases.
E-PS-09-002
Ciliated hepatitic foregut cyst in a rectal cancer patient
I. Fridrihsone*, I. Štrumfa, D. Mezale, A. Jakovlevs, M. Riekstina, A.
Abolins, I. Drike, A. Vanags, J. Gardovskis
*Pauls Stradinš Clinical, University Hospital, Dept. of Pathology, Riga,
Latvia
Objective: Ciliated hepatic foregut cyst is a rare cystic liver lesion of
presumed embryonic origin. Less than 100 cases have been reported in
English literature (Bishop et al., 2015). Our aim was to present a case of
ciliated hepatic foregut cyst in oncologic patient.
Method: Medical documentation, pathology slides and radiologic inves-
tigations were reviewed in the context of up-to-dated scientific literature.
Results: By computed tomography, a 55-year-old male was diagnosed
with unspecified lesion in the liver segment IV. The patient suffered from
rectal cancer (T4N1M1G2R0) since 2013, thus liver metastasis was
suspected. The pathological hepatic focus was resected. Grossing re-
vealed a cystic lesion (1.2x1.2x2cm) with greyish mucinous content.
Microscopic examination showed cyst lined by ciliated pseudostratified
columnar epithelium with isolated goblet cells. Cellular atypia or mitoses
were absent; proliferation fraction was low. Subepithelial connective tis-
sue and isolated bundles of smooth muscle were also found within the
cyst wall. Thus, diagnosis of ciliated hepatic foregut cyst was issued.
Conclusion: Due to variable radiographic appearance of ciliated cyst,
diagnosis can be difficult necessitating differentiation from wide spec-
trum of hepatic lesions, mostly—primary or secondary tumour. Here we
have demonstrated recently originated ciliated hepatic foregut cyst in
patient with rectal cancer history, further complicating diagnostic consid-
erations.
E-PS-09-003
Congenital poorly differentiated cystic adrenal neuroblastoma with
liver metastases: Case report
M. Jangavadze*, N. Goishvili, I. Khakhutaishvili, I. Kirvalidze
*Institute of Morphology, TSU, Pathology, Tbilisi, Georgian
Objective: The most common site of the Congenital neuroblastoma is
suprarenal medulla. Cystic metastasis to the liver is rare. Such cases can
be misdiagnosed as another tumour, such a mesenchymal hamartoma,
vascular and bile duct abnormalities, and even echinococcal cyst.
Method: Here we present a rare case of 2 months old newborn boy with
solid-cystic liver mass, misdiagnosed clinically as a Caroli’s disease.
Computed tomography revealed large solid-cystic lesion of the liver, and
right suprarenal gland. Biopsy was taken from both sites. To reveal the true
nature of the tumour, routine histology and immunohistochemistry was
done.
Results: Tumour had a small round cell tumour type histologic features -
sheets of small round cells forming small lobules and separated by fibro-
vascular septa. Formation of the Homer Wright rosettes was observed.
Tumour was negative for S100, Desmin, Vimentin, CD99, PanCK,
GFAP, EMA, aSMA, CD43. In neoplastic cells, strong expression of
the neuroendocrine markers was observed (Synaptophysin+. CD56+).
Ki67 positive in more than 40 % of cells.
Conclusion: We represent a rare case of neuroblastoma of the right ad-
renal gland with cystic metastasis of the liver, clinically misdiagnosed as a
Caroli’s disease. In cases of the liver congenital cystic lesions neuroblas-
toma should be considered in differential diagnosis.
E-PS-09 Digestive Diseases Pathology - Liver and Pancreas
Virchows Arch (2017 ) 471 (Suppl 1):S1 –S352 S322