Slide 118.Hepatocellular carcinoma, Liver

A. Brief Descriptions:

  1. Strongly linked to prevalence of HBV infection.

  2. Usually paler than the surrounding liver substance.

  3. Necrosis, hemorrhage, and bile stained may seen grossly.

B. Gross Findings

  1. Well demarcated nodules with necrosis, hemorrhage & bile stained; soft bulging cut surface.

C. Micro Findings

  1. Tumor cells have eosinophilic cytoplasm & round, vesicular nuclei with distinct nucleoli.

  2. Arranged in plates or trabeculae, usually several cell thick, & separated by sinusoidal channels which have an endothelial & very scanty reticulin, but no Kupffer cells.

  3. Or arranged in acinar pattern & solid pattern.

  4. Granular or clear cytoplasm (glycogen in cytoplasm).

  5. Sometimes pleomorphic or multinucleated giant tumor cells.

  6. Vascular invasion.

D. Others:

  1. Alfa-fetoprotein is of great diagnostic value.

E. Reference

  1. Robbins Pathologic Basis of Disease, 6th ed.  P.888~890.




Fig. 118-1 (LP)Nearly solid growth pattern replaced the normal hepatic cord architecture.




Fig. 118-2 (LP)Small solid nesty architecture is seen in this field. Note the conspicuous cellular atypia.




Fig. 118-3 (HP)Cancer cells with hyperchromatism, pleomorphism and high N/C ratio.




Fig. 118-4 (HP)In this picture, thick trabecular arrangement of cancer cells is seen. Note a mitotic figure in upper middle field.




Fig. 118-5 (HP)Acinar-like arrangement of cancer cells.




Fig. 118-6 (LP)Bizarre multinucleated cancer giant cells are not infrequently seen.