9. Hepatocellular carcinoma in cirrhosis

Overview

Staining: HE

Organ: Liver

Description:

There is no healthy liver parenchyme visible.

On the left part of the slides can we see some pseudolobules of varying size and without central veins.

On the rest of the slide can we see large nodules with cells that show pleiomorphism, atypia and mitotic activity. Some of the tumor cells show intranuclear inclusion bodies. Coagulative necrosis is also visible in the in the upper right corner inside the right large nodule.

Diagnosis: Hepatocellular carcinoma (HCC)

Recall that pseudolobules are lobules of varying size without central veins.

Causes:

• Alcoholic/viral/metabolic hepatitis -> cirrhosis -> HCC

Theory:

The pseudolobules indicate that there is cirrhosis present. The larger nodules with atypia and necrosis are nodules of the hepatocellular carcinoma.

Almost all cases of hepatocellular carcinoma develop in cirrhotic livers. The only exception is the fibrolamellar type of HCC.

The tumour cells show sign of atypia/pleiomorphism and mitotic activity.