Which histologic findings are characteristic of hepatocellular carcinoma (HCC)?

Updated: Jan 31, 2021
  • Author: Luca Cicalese, MD, FACS; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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Histology is quite variable: tumors range from well differentiated to anaplastic. The fibrolamellar subtype is associated with a better prognosis, possibly because it is not associated with cirrhosis and is more likely to be resectable. The presence of intracellular bile or staining for AFP may be helpful in distinguishing HCC from other hepatic malignancies (eg, cholangiocarcinoma). Various other immunohistochemical markers are available to establish the diagnosis of HCC. Nguyen et al reported that arginase-1 and hepatocyte paraffin antigen 1 (Hep Par 1) had the highest sensitivity for well-differentiated HCC, whereas arginase-1 and glypican-3 had the highest sensitivity for poorly differentiated HCC. [46]

Aberrations of chromosome 1 and 8 are common features of HCC that can be detected by fluorescent in situ hybridization (FISH) technique. The role of FISH in the diagnosis of hepatocellular carcinoma is still under investigation.

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