DKK1 in relation to HCV induced liver cirrhosis and HCV induced HCC curative resection

BACKGROUND

hepatitis C virus (HCV) is an RNA virus that induces hepatocarcinogenesis by mechanisms other than integration in the host cell genome. Dickkopf-1 (DKK1) expression has been studied mostly in hepatitis B virus induced HCC but not properly investigated in HCV induced HCC.

AIM

Aim: we aimed to assess serum DKK1 in HCV induced HCC, HCV induced liver cirrhosis and viral infection-free controls. Moreover, we assessed serum DKK1 level after curative resection of HCC..

METHODS

Serum DKK1 was measured by ELISA in 20 HCV induced HCC patients; both pre-resection and post-resection, 20 HCV induced liver cirrhosis patients and 20 viral infection-free controls.

RESULTS

DKK1 levels were significantly higher in HCC than cirrhosis patients (P = 0.000). DKK1 did not differ significantly between cirrhotic patients and controls (P = 0.11). DKK1 levels significantly reduced 5 days post-resection compared to their pre-resection levels (P = 0.000).

CONCLUSIONS

We documented serum DKK1 as a marker for detection of early HCC in HCV infected patients. Significant reduction of DKK1 5 days after curative resection might indicated it as a follow up marker for recurrence in surgically resected HCV induced HCC patients. Larger scale studies to follow up its level at various intervals postoperatively and evaluate its pre-resection level as a prognostic marker in HCV induced HCC patients will be needed. (Acta gastro-enterol. belg., 2016, 79, 309-313).

Borderline serous cystadenocarcinoma with coexistent angiosarcoma: an unusual form of ovarian carcinosarcoma

A 45-year-old woman presented with a short history of abdominal distension and features of intestinal obstruction. Computed tomography examination of the abdomen revealed a solid and cystic mass in the region of the left ovary, but spread within the abdomen was also noted. The ovarian tumor was removed, and an omentectomy was also performed. Microscopic examination of the ovarian tumor and metastases within the omentum showed a carcinosarcoma composed of borderline serous papillary cystadenocarcinoma and angiosarcoma. The angiosarcomatous component was the dominant tumor within the omentum. This case documents an unusual combination of epithelial and sarcomatous elements in an ovarian carcinosarcoma. The tumor behaved aggressively because of the angiosarcomatous component, and since the patient was assessed as having stage IV disease, no further treatment was offered.

Malakoplakia and tuberculosis

A 33 year old woman developed a soft mass in the left anterior neck following treatment for pulmonary tuberculosis. An incisional biopsy was performed and a cold abscess drained. Histology confirmed a diagnosis of tuberculosis. In addition, there were numerous intracellular bodies which resembled the Michaelis-Gutmann bodies of malakoplakia. This case however displayed some atypical histological, histochemical and ultrastructural features, which are highlighted in this report. The mass responded to combination antituberculous treatment.

Pacinian collagenoma

An unusual histological variant of collagenoma is described. A 36-year-old woman presented with a lump in the left hypothenar eminence. Histological examination revealed a well-delineated lesion composed of paucicellular collagen fibres arranged in concentric lamellations giving rise to an onion skin appearance. The overlying epidermis was thin and the lateral borders were demarcated by an epidermal collarette. Inflammation and xanthoma cells were absent and occasional capillaries were present. The lesion was positive for collagen stains, reticulin and CD34. This lesion represents an uncommon histological form of collagenoma or fibroma. It can be distinguished from histological look-alikes on the basis of the characteristic morphology and immunophenotype.

Ileal diverticulosis in a black patient. A case report

A 54-year-old black man presented to hospital with diarrhoea containing blood and mucus and marked loss of weight over a 1-year period. Barium enema examination revealed cobblestoning and rose-thorn ulceration with possible stricture formation of the terminal ileum. A right hemicolectomy was performed to remove inflamed sections of small and large bowel. Histological examination of the resected specimen demonstrated features of ileal diverticular disease. This is the first documented case of this disease occurring in a black patient.