Along for the Ride: Intrahepatic Cholangiocarcinoma with Concomitant LECT2 Amyloidosis

We present a case of a 69-year-old Hispanic male with a past medical history of type II diabetes mellitus who presented with a two-month history of abdominal pain. A CT scan was performed which identified a liver mass. Biopsy of the liver mass revealed infiltration of normal liver parenchyma by atyp...

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Main Authors: Phoenix D. Bell, Aaron R. Huber, Tom C. DeRoche
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Case Reports in Pathology
Online Access:http://dx.doi.org/10.1155/2020/8830763
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author Phoenix D. Bell
Aaron R. Huber
Tom C. DeRoche
author_facet Phoenix D. Bell
Aaron R. Huber
Tom C. DeRoche
author_sort Phoenix D. Bell
collection DOAJ
description We present a case of a 69-year-old Hispanic male with a past medical history of type II diabetes mellitus who presented with a two-month history of abdominal pain. A CT scan was performed which identified a liver mass. Biopsy of the liver mass revealed infiltration of normal liver parenchyma by atypical glands surrounded by pale eosinophilic material. The atypical glands were positive for CK7, while negative for CK20, CDX-2, and TTF-1, consistent with intrahepatic cholangiocarcinoma. A Congo red stain was performed, which highlighted salmon-orange areas, some with a globular appearance, around the glands and within the sinusoids and vasculature. Under polarized light, these areas displayed apple-green birefringence. These findings were consistent with amyloidosis, which was further supported by identification of ALECT2- (leukocyte chemotactic factor-2-) type amyloid on mass spectrometry. To our knowledge, this is the first documented case of intrahepatic cholangiocarcinoma arising in association with LECT2 amyloidosis.
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series Case Reports in Pathology
spelling doaj-art-eb4cfff5c2a348419aa63ce4dfac7ff32025-02-03T06:46:39ZengWileyCase Reports in Pathology2090-67812090-679X2020-01-01202010.1155/2020/88307638830763Along for the Ride: Intrahepatic Cholangiocarcinoma with Concomitant LECT2 AmyloidosisPhoenix D. Bell0Aaron R. Huber1Tom C. DeRoche2University of Rochester Medical Center, Rochester, NY, USAUniversity of Rochester Medical Center, Rochester, NY, USAKaiser Permanente Northwest, Portland, OR, USAWe present a case of a 69-year-old Hispanic male with a past medical history of type II diabetes mellitus who presented with a two-month history of abdominal pain. A CT scan was performed which identified a liver mass. Biopsy of the liver mass revealed infiltration of normal liver parenchyma by atypical glands surrounded by pale eosinophilic material. The atypical glands were positive for CK7, while negative for CK20, CDX-2, and TTF-1, consistent with intrahepatic cholangiocarcinoma. A Congo red stain was performed, which highlighted salmon-orange areas, some with a globular appearance, around the glands and within the sinusoids and vasculature. Under polarized light, these areas displayed apple-green birefringence. These findings were consistent with amyloidosis, which was further supported by identification of ALECT2- (leukocyte chemotactic factor-2-) type amyloid on mass spectrometry. To our knowledge, this is the first documented case of intrahepatic cholangiocarcinoma arising in association with LECT2 amyloidosis.http://dx.doi.org/10.1155/2020/8830763
spellingShingle Phoenix D. Bell
Aaron R. Huber
Tom C. DeRoche
Along for the Ride: Intrahepatic Cholangiocarcinoma with Concomitant LECT2 Amyloidosis
Case Reports in Pathology
title Along for the Ride: Intrahepatic Cholangiocarcinoma with Concomitant LECT2 Amyloidosis
title_full Along for the Ride: Intrahepatic Cholangiocarcinoma with Concomitant LECT2 Amyloidosis
title_fullStr Along for the Ride: Intrahepatic Cholangiocarcinoma with Concomitant LECT2 Amyloidosis
title_full_unstemmed Along for the Ride: Intrahepatic Cholangiocarcinoma with Concomitant LECT2 Amyloidosis
title_short Along for the Ride: Intrahepatic Cholangiocarcinoma with Concomitant LECT2 Amyloidosis
title_sort along for the ride intrahepatic cholangiocarcinoma with concomitant lect2 amyloidosis
url http://dx.doi.org/10.1155/2020/8830763
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