A case of *-fetoprotein-producing pulmonary carcinoma with restricted expression of hepatocyte nuclear factor-4* in hepatoid foci: a case report with studies of previous cases

Hum Pathol. 2008 Jul;39(7):1115-20. doi: 10.1016/j.humpath.2007.12.013.

Abstract

We report a case of *-fetoprotein (AFP)-producing pulmonary carcinoma with studies for messenger RNA (mRNA) expression of hepatocyte nuclear factor (HNF)-4*, which is a transcription factor that is highly expressed in the process of liver development. The patient was a 64-year-old man with a pulmonary tumor in his left lower lobe. Serum AFP was 673 ng/mL. The microscopic analysis of the surgical specimen revealed a large cell neuroendocrine carcinoma with occasional hepatoid foci. The competitive reverse transcriptase polymerase chain reaction analysis revealed that HNF-4* mRNA was expressed on the order of 10(2)- to 10(3)-fold more abundantly than control pulmonary carcinomas and normal lung tissues. In addition, AFP and HNF-4* expression was restricted in hepatoid foci. Two previously reported cases of AFP-producing pulmonary carcinoma were also positive, whereas all 18 control pulmonary carcinomas were negative for HNF-4*. These findings suggest that aberrant expression of HNF-4* is implicated in the emergence or maintenance of hepatoid foci in AFP-producing pulmonary carcinomas.

Publication types

  • Case Reports

MeSH terms

  • Biomarkers, Tumor / metabolism*
  • Carcinoma, Hepatocellular / diagnosis
  • Carcinoma, Hepatocellular / metabolism
  • Carcinoma, Neuroendocrine / metabolism*
  • Carcinoma, Neuroendocrine / pathology
  • Carcinoma, Neuroendocrine / surgery
  • Diagnosis, Differential
  • Gene Expression
  • Hepatocyte Nuclear Factor 4 / genetics
  • Hepatocyte Nuclear Factor 4 / metabolism*
  • Humans
  • Immunoenzyme Techniques
  • Lung Neoplasms / metabolism*
  • Lung Neoplasms / pathology
  • Lung Neoplasms / surgery
  • Male
  • Middle Aged
  • RNA, Messenger / metabolism
  • Reverse Transcriptase Polymerase Chain Reaction
  • alpha-Fetoproteins / metabolism*

Substances

  • Biomarkers, Tumor
  • Hepatocyte Nuclear Factor 4
  • RNA, Messenger
  • alpha-Fetoproteins