Difference between revisions of "Liver neoplasms"
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===Clinical=== | ===Clinical=== | ||
*Serum AFP elevated - in approx. 50% of patients.<ref>GLP | *Serum AFP elevated - in approx. 50% of patients.<ref>{{Ref GLP|588}}</ref> | ||
*Treatments: RFA (radiofrequency ablation), ethanol ablation, liver resection, liver transplant.<ref name=emed_hcc>[http://emedicine.medscape.com/article/282814-overview http://emedicine.medscape.com/article/282814-overview]</ref> | *Treatments: RFA (radiofrequency ablation), ethanol ablation, liver resection, liver transplant.<ref name=emed_hcc>[http://emedicine.medscape.com/article/282814-overview http://emedicine.medscape.com/article/282814-overview]</ref> | ||
*Mean survival at time of diagnosis ~6 months.<ref name=emed_hcc/> | *Mean survival at time of diagnosis ~6 months.<ref name=emed_hcc/> | ||
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**Cytoplasmic hyperchromasia, clearing or lighter staining. | **Cytoplasmic hyperchromasia, clearing or lighter staining. | ||
Varied architecture - may be:<ref>GLP | Varied architecture - may be:<ref>{{Ref GLP|590-1}}</ref> | ||
*Pseudoglandular - can be confused with adenocarcinoma. | *Pseudoglandular - can be confused with adenocarcinoma. | ||
*Trabecular. | *Trabecular. | ||
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*HCC with trabecular morphology has some resemblance to normal liver - but has extra cells. | *HCC with trabecular morphology has some resemblance to normal liver - but has extra cells. | ||
*Fibrolamellar - better prognosis, classically in young adults. | *Fibrolamellar - better prognosis, classically in young adults. | ||
*Stroma is usually scant.<ref>GLP | *Stroma is usually scant.<ref>{{Ref GLP|591}}</ref> | ||
ASIDE: | ASIDE: | ||
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====Fibrolamellar HCC==== | ====Fibrolamellar HCC==== | ||
Features:<ref>GLP | Features:<ref>{{Ref GLP|595-6}}</ref> | ||
*Large polygonal tumours cells with: | *Large polygonal tumours cells with: | ||
**Graunular eosinophilic cytoplasm. | **Graunular eosinophilic cytoplasm. | ||
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===Epidemiology=== | ===Epidemiology=== | ||
*Rare - approximately 1/5 the incidence of HCC.<ref>GLP | *Rare - approximately 1/5 the incidence of HCC.<ref>{{Ref GLP|608}}</ref> | ||
*More common among asians. | *More common among asians. | ||
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===Micro=== | ===Micro=== | ||
Features:<ref>GLP | Features:<ref>{{Ref GLP|609}}</ref> | ||
*Usually an ''adenocarcinoma'', i.e. gland forming with: | *Usually an ''adenocarcinoma'', i.e. gland forming with: | ||
**Cuboidal or columnar mucin producing cells, and | **Cuboidal or columnar mucin producing cells, and | ||
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===IHC=== | ===IHC=== | ||
Classic IHC pattern:<ref>GLP | Classic IHC pattern:<ref>{{Ref GLP|609}}</ref> | ||
*CK7 +. | *CK7 +. | ||
*CK20 +/-. | *CK20 +/-. | ||