Hepatocellular carcinoma

From patholines.org
Jump to navigation Jump to search

Author: Mikael Häggström [note 1]

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.
  • Steatotic hepatocellular carcinoma is a common variant, found most commonly in small, well-differentiated tumors.[3]
  • Portal triads commonly persist in well-differentiated hepatocellular carcinomas.[4]

Differentiation

Differentiations of hepatocellular carcinoma are:[2]

Well-differentiated HCC.
  • 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 HCC.
  • Moderately differentiated:
  • Trabecular pattern at least 4 cells thick
  • Larger cells with more eosinophilic cytoplasm
  • Distinct nucleoli
  • Pseudoglands
Poorly differentiated HCC.
  • 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

  1. 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

  1. 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. 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
  3. 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:10.1111/his.13029. ISSN 03090167. 
  4. 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:10.1002/hep.1840160120. ISSN 02709139. 

Image sources