《Slide 118.》Hepatocellular carcinoma, Liver
A. Brief Descriptions:
Strongly linked to prevalence of HBV infection.
Usually paler than the surrounding liver substance.
Necrosis, hemorrhage, and bile stained may seen grossly.
B. Gross Findings:
Well demarcated nodules with necrosis, hemorrhage & bile stained; soft bulging cut surface.
C. Micro Findings:
Tumor cells have eosinophilic cytoplasm & round, vesicular nuclei with distinct nucleoli.
Arranged in plates or trabeculae, usually several cell thick, & separated by sinusoidal channels which have an endothelial & very scanty reticulin, but no Kupffer cells.
Or arranged in acinar pattern & solid pattern.
Granular or clear cytoplasm (glycogen in cytoplasm).
Sometimes pleomorphic or multinucleated giant tumor cells.
Vascular invasion.
D. Others:
Alfa-fetoprotein is of great diagnostic value.
E. Reference:
Robbins Pathologic Basis of Disease, 6th ed. P.888~890.
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【 Fig. 118-1 (LP)】Nearly solid growth pattern replaced the normal hepatic cord architecture.
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【 Fig. 118-2 (LP)】Small solid nesty architecture is seen in this field. Note the conspicuous cellular atypia.
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【 Fig. 118-3 (HP)】Cancer cells with hyperchromatism, pleomorphism and high N/C ratio.
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【 Fig. 118-4 (HP)】In this picture, thick trabecular arrangement of cancer cells is seen. Note a mitotic figure in upper middle field.
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【 Fig. 118-5 (HP)】Acinar-like arrangement of cancer cells.
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【 Fig. 118-6 (LP)】Bizarre multinucleated cancer giant cells are not infrequently seen.