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Differential diagnosis of primary and metastatic carcinomas of the liver can be problematic and may require immunohistochemical work-up. Recently, new immunohistochemical markers have been introduced with promising results in this area. We studied three of these markers, human hepatocyte antibody (HepPar-1), human epithelial-related antigen (MOC-31), and thyroid transcription factor-1 (TTF-1), in cell-block sections of fine-needle aspirations from 30 hepatocellular carcinomas and 27 metastatic carcinomas from various sites. Of 27 metastatic carcinomas, all but one were positive for MOC-31 and, all but one were negative for HepPar-1. TTF-1 was positive only in the nuclei of metastatic poorly differentiated neuroendocrine carcinoma from the lung. Of 30 hepatocellular carcinomas, 26 were positive for HepPar-1 and all were negative for MOC-31, while TTF-1 showed cytoplasmic staining in 23 cases. HepPar-1, MOC-31, and TTF-1 are complementary markers in the differential diagnosis of primary and metastatic carcinomas of the liver, with high sensitivity and specificity.
Gökden et al. (Tue,) studied this question.