Difference between revisions of "Liver neoplasms"
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===Microscopy=== | ===Microscopy=== | ||
Features: | Features: | ||
*Sheets or cords of cells with mild variation of cell and nuclear size.<ref>{{Ref PBoD|923}}</ref> | *Sheets or cords of cells with mild variation of cell and nuclear size.<ref name=Ref_PBoD923>{{Ref PBoD|923}}</ref> | ||
*Cords of cells upto 3 cells thick.<ref>STC S.19, 19 Jan 2009.</ref> | *Cords of cells upto 3 cells thick.<ref>STC S.19, 19 Jan 2009.</ref> | ||
*Cells may have cytoplasmic clearing due to glycogen or be pale - '''obvious if seen'''. | *Cells may have cytoplasmic clearing due to glycogen or be pale - '''obvious if seen'''. | ||
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==Hepatoblastoma== | ==Hepatoblastoma== | ||
*Most common liver cancer in children.<ref>{{Ref PBoD|923}}</ref><ref>URL: [http://emedicine.medscape.com/article/986802-overview http://emedicine.medscape.com/article/986802-overview]. Accessed on: 29 November 2009.</ref> | *Most common liver cancer in children.<ref name=Ref_PBoD923>{{Ref PBoD|923}}</ref><ref>URL: [http://emedicine.medscape.com/article/986802-overview http://emedicine.medscape.com/article/986802-overview]. Accessed on: 29 November 2009.</ref> | ||
*Surgical biopsy; core needle biopsy ''not'' done as as lesion is vascular. | *Surgical biopsy; core needle biopsy ''not'' done as as lesion is vascular. | ||
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===Epidemiology=== | ===Epidemiology=== | ||
*Highest where prevalence of hepatitis B virus (HBV) is high.<ref>{{Ref PBoD|924}}</ref> | *Highest where prevalence of hepatitis B virus (HBV) is high.<ref name=Ref_PBoD924>{{Ref PBoD|924}}</ref> | ||
*HCC generally arises in the setting of cirrhosis. | *HCC generally arises in the setting of cirrhosis. | ||
**HBV commonly leads to HCC without cirrhosis<ref>{{Ref PBoD|924}}</ref> - may be ''without'' cirrhosis as it is regressed. | **HBV commonly leads to HCC without cirrhosis<ref name=Ref_PBoD924>{{Ref PBoD|924}}</ref> - may be ''without'' cirrhosis as it is regressed. | ||
Risk factors:<ref>{{Ref PBoD|924}}</ref><ref name=pmid18333156>{{cite journal |author=Leong TY, Leong AS |title=Epidemiology and carcinogenesis of hepatocellular carcinoma |journal=HPB (Oxford) |volume=7 |issue=1 |pages=5–15 |year=2005 |pmid=18333156 |pmc=2023917 |doi=10.1080/13651820410024021 |url=}}</ref> | Risk factors:<ref name=Ref_PBoD924>{{Ref PBoD|924}}</ref><ref name=pmid18333156>{{cite journal |author=Leong TY, Leong AS |title=Epidemiology and carcinogenesis of hepatocellular carcinoma |journal=HPB (Oxford) |volume=7 |issue=1 |pages=5–15 |year=2005 |pmid=18333156 |pmc=2023917 |doi=10.1080/13651820410024021 |url=}}</ref> | ||
*Chronic alcoholism. | *Chronic alcoholism. | ||
*Hepatitis C virus (HCV) - chronic infection. | *Hepatitis C virus (HCV) - chronic infection. | ||
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===Gross=== | ===Gross=== | ||
Features:<ref>{{Ref PBoD|925}}</ref> | Features:<ref name=Ref_PBoD925>{{Ref PBoD|925}}</ref> | ||
*Unifocal, multifocal or diffusely infiltrative. | *Unifocal, multifocal or diffusely infiltrative. | ||
**Tumours are multifocal in approx. 50% of cases;<ref name=pmid17696722>{{cite journal |author=Yusuf MA, Badar F, Meerza F, ''et al.'' |title=Survival from hepatocellular carcinoma at a cancer hospital in Pakistan |journal=Asian Pac. J. Cancer Prev. |volume=8 |issue=2 |pages=272–4 |year=2007 |pmid=17696722 |doi= |url=}}</ref><ref name=pmid11676064>{{cite journal |author=Sharieff S, Burney KA, Ahmad N, Salam A, Siddiqui T |title=Radiological features of hepatocellular carcinoma in Southern Pakistan |journal=Trop Doct |volume=31 |issue=4 |pages=224–5 |year=2001 |month=October |pmid=11676064 |doi= |url=}}</ref> some authors have suggested it is upto 75% of cases.<ref name=emed_hcc/> | **Tumours are multifocal in approx. 50% of cases;<ref name=pmid17696722>{{cite journal |author=Yusuf MA, Badar F, Meerza F, ''et al.'' |title=Survival from hepatocellular carcinoma at a cancer hospital in Pakistan |journal=Asian Pac. J. Cancer Prev. |volume=8 |issue=2 |pages=272–4 |year=2007 |pmid=17696722 |doi= |url=}}</ref><ref name=pmid11676064>{{cite journal |author=Sharieff S, Burney KA, Ahmad N, Salam A, Siddiqui T |title=Radiological features of hepatocellular carcinoma in Southern Pakistan |journal=Trop Doct |volume=31 |issue=4 |pages=224–5 |year=2001 |month=October |pmid=11676064 |doi= |url=}}</ref> some authors have suggested it is upto 75% of cases.<ref name=emed_hcc/> | ||
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Risks: | Risks: | ||
*Infection - liver flukes (endemic to Southeast Asia): | *Infection - liver flukes (endemic to Southeast Asia): | ||
**''Opisthorchis sinensis''.<ref>{{Ref PBoD|926}}</ref> | **''Opisthorchis sinensis''.<ref name=Ref_PBoD926>{{Ref PBoD|926}}</ref> | ||
**''Opisthorchis viverrini''.<ref name=pmid20202771>{{cite journal |author=de Martel C, Plummer M, Franceschi S |title=Cholangiocarcinoma: Descriptive epidemiology and risk factors |journal=Gastroenterol Clin Biol |volume= |issue= |pages= |year=2010 |month=March |pmid=20202771 |doi=10.1016/j.gcb.2010.01.008 |url=}}</ref> | **''Opisthorchis viverrini''.<ref name=pmid20202771>{{cite journal |author=de Martel C, Plummer M, Franceschi S |title=Cholangiocarcinoma: Descriptive epidemiology and risk factors |journal=Gastroenterol Clin Biol |volume= |issue= |pages= |year=2010 |month=March |pmid=20202771 |doi=10.1016/j.gcb.2010.01.008 |url=}}</ref> | ||
*Caroli disease - rare congenital disease.<ref name=pmid17418061>{{cite journal |author=Ananthakrishnan AN, Saeian K |title=Caroli's disease: identification and treatment strategy |journal=Curr Gastroenterol Rep |volume=9 |issue=2 |pages=151–5 |year=2007 |month=April |pmid=17418061 |doi= |url=}}</ref> | *Caroli disease - rare congenital disease.<ref name=pmid17418061>{{cite journal |author=Ananthakrishnan AN, Saeian K |title=Caroli's disease: identification and treatment strategy |journal=Curr Gastroenterol Rep |volume=9 |issue=2 |pages=151–5 |year=2007 |month=April |pmid=17418061 |doi= |url=}}</ref> | ||