Pathologic and molecular features of hepatocellular carcinoma: An update

Abstract

Morphological diversity and several new distinct pathologic subtypes of hepatocellular carcinoma (HCC) are now well-recognized. Recent advances in tumor genomics and transcriptomics have identified several recurrent somatic/genetic alterations that are closely related with histomorphological subtypes and have therefore, greatly improved our understanding of HCC pathogenesis. Pathologic subtyping allows for a diagnosis which is clinically helpful and can have important implication in patient prognostication as some of these subtypes are extremely aggressive with vascular invasion, early recurrence, and worst outcomes. Several targeted treatments are now being considered in HCC, and the reporting of subtypes may be quite useful for personalized therapeutic purpose. This manuscript reviews the recently identified histomorphological subtypes and molecular alterations in HCC.

Radiomics Analysis on Noncontrast CT for Distinguishing Hepatic Hemangioma (HH) and Hepatocellular Carcinoma (HCC)

“…Pathologically, HCC evolves from dysplastic lesions (dysplastic foci/dysplastic nodules) with bleeding, calcification, and necrosis tissue [ 16 , 17 ]. In contrast, HH stems from vascular malformation and contains rich sinusoids [ 18 ].…”

Macrotrabecular-Massive Hepatocellular Carcinoma: What Should We Know?

“…Therefore, they have not aroused the interest of clinicians. However, for MTM-HCC, the diagnostic consistency of pathologists after core biopsy is high, 58 so the utility of preoperative biopsies should be re-examined. In addition, based on its different molecular types and carcinogenic pathways, MTM-HCC may be relatively sensitive to angiogenesis inhibitors, such as anti-Ang-2 and anti-VEGFA antibody.…”

Understanding the Immunoenvironment of Primary Liver Cancer: A Histopathology Perspective

“…Up to 35% of HCCs can be further subclassified into eight distinct histological subtypes with varying clinicopathological outcomes: steatohepatitic (the most common subtype), fibrolamellar, scirrhous, clear cell type, macrotrabecular massive, chromophobe, neutrophil-rich and lymphocyte-rich. 1 As well as displaying histologically contrasting properties, each subtype displays distinct molecular and immune interactions with the tumour microenvironment, 71 , 72 thus contributing further to the multiple layers of heterogeneity that exist in HCC.…”