Hepatocellular carcinoma pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2] Mohamad Alkateb, MBBCh [3]
Overview
On microscopic histopathological analysis, large polygonal tumours cells with graunular eosinophilic cytoplasm or layered dense collagen bundles are characteristic findings of hepatocellular carcinoma.
Gross Pathology
On gross pathology, hepatocellular carcinoma have the following characteristic findings:
- 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
On microscopic histopathological analysis, hepatocellular carcinoma have the following characteristic findings:
- Large polygonal tumours cells with:
- Graunular eosinophilic cytoplasm
- Low NC ratio
- Layered dense collagen bundles [1]
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