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Pathology - Hepatocellular carcinoma
Definition • A malignant epithelial tumor of the liver originating from hepatocytes.
Epidemiology • Ubiquitous globally, although exhibiting significant geographical diversity. • Incidence rates closely align with HBV infection rates, rendering hepatocellular carcinoma (HCC) especially prevalent in some regions of Africa and Asia.
Etiology
Hepatocellular carcinoma typically develops in the context of liver cirrhosis. Chronic hepatitis B and haemochromatosis are notably carcinogenic substrates. Dietary consumption of aflatoxins produced by Aspergillus fungi is recognized as a strong carcinogen for the liver.
Carcinogenesis • The inactivation of tumor suppressor genes, such as TP53, is prevalent. • Activating mutations of oncogenes seem to be infrequent. The Hepatitis B X gene product impairs p53 functionality and obstructs nucleotide excision repair.
Presentation • Arrives late with nonspecific weight loss and abdominal discomfort. • Established cirrhotics may be identified through the evaluation of an increasing serum alpha-fetoprotein or with ultrasound monitoring.
Macroscopy: Expansile neoplastic tumor in the liver, frequently accompanied by satellite deposits. • The tumor may exhibit a green hue as a result of bile production. • Differentiating tumor deposits from cirrhotic nodules can be challenging.
Histopathology: Classical hepatocellular carcinoma (HCC) consists of epithelial cells akin to hepatocytes, generally proliferating in trabecular formations that resemble thicker hepatic cell plates. The tumor may exhibit bile production. Fibrolamellar HCC is a rare yet unusual form that often occurs in young people without preexisting cirrhosis. Histologically, the tumor consists of clusters of exceptionally large neoplastic cells with plentiful granular pink cytoplasm interspersed with dense fibrous bands.
Prognosis: Generally unfavorable, with 5-year survival rates below 5%. Fibrolamellar hepatocellular carcinoma exhibits a marginally improved prognosis, with 5-year survival rates of 60%.
Definition • A malignant epithelial tumor of the liver originating from hepatocytes.
Epidemiology • Ubiquitous globally, although exhibiting significant geographical diversity. • Incidence rates closely align with HBV infection rates, rendering hepatocellular carcinoma (HCC) especially prevalent in some regions of Africa and Asia.
Etiology
Hepatocellular carcinoma typically develops in the context of liver cirrhosis. Chronic hepatitis B and haemochromatosis are notably carcinogenic substrates. Dietary consumption of aflatoxins produced by Aspergillus fungi is recognized as a strong carcinogen for the liver.
Carcinogenesis • The inactivation of tumor suppressor genes, such as TP53, is prevalent. • Activating mutations of oncogenes seem to be infrequent. The Hepatitis B X gene product impairs p53 functionality and obstructs nucleotide excision repair.
Presentation • Arrives late with nonspecific weight loss and abdominal discomfort. • Established cirrhotics may be identified through the evaluation of an increasing serum alpha-fetoprotein or with ultrasound monitoring.
Macroscopy: Expansile neoplastic tumor in the liver, frequently accompanied by satellite deposits. • The tumor may exhibit a green hue as a result of bile production. • Differentiating tumor deposits from cirrhotic nodules can be challenging.
Histopathology: Classical hepatocellular carcinoma (HCC) consists of epithelial cells akin to hepatocytes, generally proliferating in trabecular formations that resemble thicker hepatic cell plates. The tumor may exhibit bile production. Fibrolamellar HCC is a rare yet unusual form that often occurs in young people without preexisting cirrhosis. Histologically, the tumor consists of clusters of exceptionally large neoplastic cells with plentiful granular pink cytoplasm interspersed with dense fibrous bands.
Prognosis: Generally unfavorable, with 5-year survival rates below 5%. Fibrolamellar hepatocellular carcinoma exhibits a marginally improved prognosis, with 5-year survival rates of 60%.
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