Difference between revisions of "Hepatocellular carcinoma"
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===Differentiation=== | ===Differentiation=== | ||
Revision as of 10:48, 11 February 2021
Author:
Mikael Häggström [note 1]
Contents
Presentations
Hepatocellular carcinoma is the most common diagnosis for liver tumors.:[1]
Microscopic evaluation
Hepatocellular carcinoma typically displays:[2]
- Trabecular pattern surrounded by layer of flattened endothelial cells.
- Presence of sinusoidal vessels surrounding tumor cells
- Scant stroma, and minimal desmoplasia
- Polygonal cells with distinct cell membranes
- Abundant granular eosinophilic cytoplasm
- Nuclei with increased N/C ratio, round nuclei with coarse chromatin and thickened nuclear membrane, and may have prominent nucleoli.
Needle biopsy.
Needle biopsy.
Needle biopsy.
FNA.
FNA clot section.
FNA clot section.
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Hepatocellular adenoma versus carcinoma
Histopathology of inflammatory hepatocellular adenoma, with inflammatory cells and minor atypia.[3]
A hepatocellular adenoma, in contrast to a carcinoma, has a well-defined border between the lesion and background liver, and is composed of hepatocytes with less significant cytologic atypia.[4]
Both hepatocellular adenoma and well-differentiated hepatocellular carcinoma may display:
- Steatosis: A steatotic hepatocellular carcinoma is a common variant, found most commonly in small, well-differentiated tumors.[5]
- Portal triads, which commonly persist in well-differentiated hepatocellular carcinomas.[6]
Differentiation
Differentiations of hepatocellular carcinoma are:[2]
- Well differentiated:
- Thin plates (1 - 3 hepatocytes thick)
- Hepatocytes are smaller than normal
- Abnormal reticulin network
- Minimal nuclear atypia
- Nuclear density of 2x compared to normal liver
- Moderately differentiated:
- Trabecular pattern at least 4 cells thick
- Larger cells with more eosinophilic cytoplasm
- Distinct nucleoli
- Pseudoglands
- Poorly differentiated:
- Large tumor cells with hyperchromatic nuclei in compact growth pattern
- Rare trabeculae or bile
- Prominent pleomorphism
- May have spindle cell or small cell areas
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
Main page
References
- ↑ Table 37.2 in: Sternberg, Stephen (2012). Sternberg's diagnostic surgical pathology . Place of publication not identified: LWW. ISBN 978-1-4511-5289-0. OCLC 953861627.
- ↑ 2.0 2.1 Deepali Jain. Liver & intrahepatic bile ducts - Hepatocellular carcinoma - Hepatocellular carcinoma overview. PathologyOutlines. Topic Completed: 1 February 2012. Minor changes: 30 September 2020
- ↑ Bioulac-Sage, Paulette; Sempoux, Christine; Possenti, Laurent; Frulio, Nora; Laumonier, Hervé; Laurent, Christophe; Chiche, Laurence; Frédéric Blanc, Jean; et al. (2013). "Pathological Diagnosis of Hepatocellular Cellular Adenoma according to the Clinical Context ". International Journal of Hepatology 2013: 1–13. doi:. ISSN 2090-3448.
- ↑ Author: Avani Pendse, M.D., Ph.D.. Liver & intrahepatic bile ducts - Benign / nonneoplastic - Hepatocellular adenoma. Pathology Outlines. Topic Completed: 1 October 2018. Minor changes: 30 September 2020
- ↑ Chan, Anthony W H; Yu, Shuangni; Yu, Yau-Hei; Tong, Joanna H M; Wang, Lei; Tin, Edith K Y; Chong, Charing C N; Chan, Stephen L; et al. (2016). "Steatotic hepatocellular carcinoma: a variant associated with metabolic factors and late tumour relapse ". Histopathology 69 (6): 971–984. doi:. ISSN 03090167.
- ↑ Motohashi, Ikuko; Okudaira, Masahiko; Takai, Tomoko; Kaneko, Satoshi; Ikeda, Noriaki (1992). "Morphological differences between hepatocellular carcinoma and hepatocellular carcinomalike lesions ". Hepatology 16 (1): 118–126. doi:. ISSN 02709139.
Image sources
