Difference between revisions of "Hepatocellular carcinoma"

 

 

Hepatocellular carcinoma with acini. A. Fibrous bands dissect hepatocyte nodules, mostly hepatoma. B. The fibrous band on right bears proliferating bile ductules; acinar arrangement on left shows holes much larger than canaliculi. C. The tumor has cancerous nuclei; note the bile which makes for absolute diagnostic certainty [arrow]. D. Noncancerous hepatocytes on left can be compared with tumor cells on right. Note increased nuclear crowding & a subtle increment in cytoplasmic basophilia in tumor.

 

 

Hepatocellular carcinoma, steatohepatitic variant. A. Fragments of tumor at low power mimic normal hepatocyte groups without portal triads. B. Vacuoles, mostly small, occasionally become large enough to warrant the term “macrovesicular” [green arrows]. Note Mallory hyalin [red arrows]. D. Chronic inflammatory cells bound some cancer cells. D. Nuclear inclusions [arrows] are occasionally prominent [arrows].

 

 

Hepatocellular carcinoma, clear cell variant. Much more difficult on biopsy than on resection is the specific identification of the clear cell variant, although it was done here. Variants are of little clinical significance apart from the fibrolamellar variant. A. Tumor fragment masses with clearing contrast with pink liver fragments. B. Tumor cell cytoplasm on the core biopsy varies, often clear, often light pink and foamy. C. PAS without diastase shows brightly positive tumor cytoplasm. D. Modestly variable, rounded nuclei show open chromatin and nucleoli. Individual pyknotic nuclei (black arrows) are insufficient as evidence of necrosis sufficient to increase grade. D. PAS with diastase shows the material is glycogen. E. At resection, the cytoplasmic clarity at low power is more impressive than on biopsy. F. The high power view of the resection specimen shows the cytoplasm is truly clear. Arrows point to Mallory bodies.