Difference between revisions of "Liver neoplasms"

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===Clinical===
===Clinical===
*Serum AFP elevated - in approx. 50% of patients.<ref>GLP P.588.</ref>
*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 P.590-1.</ref>
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 P.591.</ref>
*Stroma is usually scant.<ref>{{Ref GLP|591}}</ref>


ASIDE:
ASIDE:
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====Fibrolamellar HCC====
====Fibrolamellar HCC====
Features:<ref>GLP PP.595-6.</ref>
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 P.608.</ref>
*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 P.609.</ref>
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 P.609.</ref>
Classic IHC pattern:<ref>{{Ref GLP|609}}</ref>
*CK7 +.
*CK7 +.
*CK20 +/-.
*CK20 +/-.
48,830

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