Hepatocellular carcinoma pathophysiology: Difference between revisions
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===Gross Pathology=== | ===Gross Pathology=== | ||
* | * Nodular or diffusely infiltrative | ||
:* The nodular type may be unifocal (large mass) or multifocal (when developed as a complication of cirrhosis). Tumor nodules are round to oval, grey or green (if the tumor produces bile), well circumscribed but not encapsulated | :* The nodular type may be unifocal (large mass) or multifocal (when developed as a complication of cirrhosis). Tumor nodules are round to oval, grey or green (if the tumor produces bile), well circumscribed but not encapsulated | ||
:* Tumours are multifocal in approx. 50% of cases; some authors have suggested it is upto 75% of cases | :* Tumours are multifocal in approx. 50% of cases; some authors have suggested it is upto 75% of cases |
Revision as of 13:34, 4 September 2015
Hepatocellular carcinoma Microchapters |
Differentiating Hepatocellular carcinoma from other Diseases |
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Diagnosis |
Treatment |
Case Studies |
Hepatocellular carcinoma pathophysiology On the Web |
American Roentgen Ray Society Images of Hepatocellular carcinoma pathophysiology |
Risk calculators and risk factors for Hepatocellular carcinoma pathophysiology |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Gross Pathology
- Nodular or diffusely infiltrative
- The nodular type may be unifocal (large mass) or multifocal (when developed as a complication of cirrhosis). Tumor nodules are round to oval, grey or green (if the tumor produces bile), well circumscribed but not encapsulated
- Tumours are multifocal in approx. 50% of cases; some authors have suggested it is upto 75% of cases
- The diffuse type is poorly circumscribed and infiltrates the portal veins, or the hepatic veins (rarely)
- Pale in relation to surrounding liver or green (due to bile secretion)
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Hepatocelluler carcinoma. The image shows a longitudinal slice taken through the full length of the liver.
(Courtesy of Ed Uthman, MD) -
The tumor is at the top, cirrhotic liver at the bottom, and a fibrous reaction in between. Hepatocellular carcinomas can have a variety of gross patterns, including multinodular / multifocal, such as this one.
(Courtesy of Ed Uthman, MD)
Microscopic Pathology
Microscopically, there are four architectural and cytological types (patterns) of hepatocellular carcinoma: fibrolamellar, pseudoglandular (adenoid), pleomorphic (giant cell) and clear cell. In well differentiated forms, tumor cells resemble hepatocytes, form trabeculae, cords and nests, and may contain bile pigment in cytoplasm. In poorly differentiated forms, malignant epithelial cells are discohesive, pleomorphic, anaplastic, giant. The tumor has a scant stroma and central necrosis because of the poor vascularization.1