Histopathologic features of hepatocellular carcinoma

Abstract

Paradoxically, with the recognized increase in hepatocellular carcinoma, liver biopsy is used less frequently for diagnosis unless there are “atypical” imaging characteristics.[1, 2] Thus, unless pathologists practice in a center with high liver surgery volume, experience with this tumor may diminish. However, whether for tissue acquisition for management decisions of the atypical lesions, the incidental lesion encountered in a “blind” percutaneous biopsy, or for final diagnostic reporting of resected or transplanted hepatectomies, familiarity with the histopathologic lesions of hepatocellular carcinoma remains important for practicing pathologists. As noted in recent reviews, clinical management choices and decisions, and prognosis of primary liver carcinoma are fields of rapid growth. Arguments are now being made that for optimum clinical outcomes, management also necessitates the most reliable classification of tumors, including histopathologic evaluation.[3-5] This review discusses current criteria, useful immunohistochemistry stains, and differential diagnostic considerations for hepatocellular carcinoma.