Pathology of hepatocellular carcinoma and benign and malignant mimickers

Research output: Contribution to journalReview article

Abstract

Malignant tumors of the liver may be derived from the native liver epithelium and mesenchyma, from heterotopic tissues or metastases from any primary site imaginable. While the majority of cancers that involve the liver are metastatic, among patients with cirrhosis, hepatocellular carcinoma is actually more common. Although advances in the sensitivity and accuracy of radiographic imaging combined with other clinical parameters have significantly improved the diagnosis of most lesions, a biopsy diagnosis for confirmation remains necessary. Many benign lesions such as fibrous scars, healed granulomas, bile duct hamartoma and adenoma, and nodular hyperplasia may have a gross appearance indistinguishable from metastic carcinoma. Thus, it is imperative that every lesion suggestive of liver metastases be confirmed microscopically. The use of sophisticated imaging techniques to detect and guide the biopsy of relatively small hepatocellular nodules in patients with chronic liver disease will continue to provide diagnostic challenges. At the time of biopsy, consideration should be given to the triage of portions into fixative for electron microscopy, and frozen or fresh processing for flow cytometry, chromosome/oncogene analysis or other adjunctive studies depending on the most likely diagnostic possibilities and the availability of such analysis at a particular institution. A framework for the understanding of the salient clinicopathologic features of the more important hepatic tumors will be discussed.

Original languageEnglish (US)
Pages (from-to)325-238
Number of pages88
JournalSeminars in Interventional Radiology
Volume14
Issue number3
StatePublished - Jan 1 1997

Fingerprint

Hepatocellular Carcinoma
Pathology
Liver
Biopsy
Bile Duct Adenoma
Neoplasm Metastasis
Choristoma
Fixatives
Hamartoma
Triage
Mesoderm
Liver Neoplasms
Granuloma
Oncogenes
Hyperplasia
Cicatrix
Liver Diseases
Neoplasms
Electron Microscopy
Flow Cytometry

Keywords

  • Benign hepatic tumors
  • Diagnosis
  • Hepatic metastases
  • Hepatocellular carcinoma
  • Histology
  • Pathology

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Pathology of hepatocellular carcinoma and benign and malignant mimickers. / Radio, Stanley J.

In: Seminars in Interventional Radiology, Vol. 14, No. 3, 01.01.1997, p. 325-238.

Research output: Contribution to journalReview article

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AB - Malignant tumors of the liver may be derived from the native liver epithelium and mesenchyma, from heterotopic tissues or metastases from any primary site imaginable. While the majority of cancers that involve the liver are metastatic, among patients with cirrhosis, hepatocellular carcinoma is actually more common. Although advances in the sensitivity and accuracy of radiographic imaging combined with other clinical parameters have significantly improved the diagnosis of most lesions, a biopsy diagnosis for confirmation remains necessary. Many benign lesions such as fibrous scars, healed granulomas, bile duct hamartoma and adenoma, and nodular hyperplasia may have a gross appearance indistinguishable from metastic carcinoma. Thus, it is imperative that every lesion suggestive of liver metastases be confirmed microscopically. The use of sophisticated imaging techniques to detect and guide the biopsy of relatively small hepatocellular nodules in patients with chronic liver disease will continue to provide diagnostic challenges. At the time of biopsy, consideration should be given to the triage of portions into fixative for electron microscopy, and frozen or fresh processing for flow cytometry, chromosome/oncogene analysis or other adjunctive studies depending on the most likely diagnostic possibilities and the availability of such analysis at a particular institution. A framework for the understanding of the salient clinicopathologic features of the more important hepatic tumors will be discussed.

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