Primary Liver Cancers—Part 1

Abstract

Hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC) are the 2 most common primary malignant liver tumors, with hepatocellular and bile ductular differentiation, respectively. This article reviews the key histopathological findings of these 2 primary liver cancers and includes a review of the role of ancillary testing for differential diagnosis, risk stratification according to the American Joint Committee on Cancer (AJCC) staging recommendation, and a review of precancerous lesions. A literature review was conducted to identify articles with information relevant to precancerous precursors, current histopathological classification, ancillary testing, and risk stratification of primary malignant liver tumors. The histomorphology of normal liver, preinvasive precursors, primary malignancies, and morphological variants, and the utilization of ancillary tests for the pathological diagnosis are described. Dysplastic nodules are the preinvasive precursors of HCC, and intraductal papillary neoplasms of bile ducts and biliary intraepithelial neoplasia are the preinvasive precursors of CC. Benign liver nodules including focal nodular hyperplasia and adenomas are included in this review, since some forms of adenomas progress to HCC and often they have to be differentiated from well-differentiated HCC. A number of morphological variants of HCC have been described in the literature, and it is necessary to be aware of them in order to render the correct diagnosis. Risk stratification is still dependent on the AJCC staging system. The diagnosis of primary liver carcinomas is usually straightforward. Application of the appropriate ancillary studies aids in the differential diagnosis of difficult cases. The understanding of the carcinogenesis of these malignancies has improved with the standardization of the pathological classification of preinvasive precursors and studies of the molecular pathogenesis. Risk stratification still depends on pathological staging.

Feasibility of terahertz imaging for discrimination of human hepatocellular carcinoma

“…Due to the heterogeneity of HCC, histomorphologic appearance of HCC varies greatly from patient to patient and even in a single patient[18]. Different stages of intratumoral differentiation and growth patterns can be observed, where in some cases HCC cells are mixed with normal cells[19].…”

<p>MiR-145 Regulates the Chemoresistance of Hepatic Carcinoma Cells Against 5-Fluorouracil by Targeting Toll-Like Receptor 4</p>

“…A total of 102 HCC tissue specimens and corresponding normal paracancerous tissue specimens were sampled from patients undergoing surgery in The first Hospital of Jilin University from March 2011 to June 2014. All the patients were confirmed with HCC 17 and had not received any related treatment before admission, and their expected survival time was longer than one month. This study was carried out with the permission from the ethics committee of the First Hospital of Jilin University and informed consent forms from all participants and it was in accordance with the Helsinki Declaration.…”

Mitogen-Activated Protein Kinases (MAPKs) and Cholangiocarcinoma: The Missing Link

“…Matrix metalloproteinases that degrade and remodel the ECM including MMP1, MMP2, MMP3, and MMP9 are strongly expressed in CCA and are associated with invasive tumors. CCA does not always exhibit a tubular contour, which is easily recognized in histopathological studies; instead, cancer cells often appear nodular or exhibit a form of HCC resembling a neuroendocrine or mixed solid shape [173]. CCA cells usually grow along the wall of the portal vein in connective tissue and directly intrude into the nearby bile ducts.…”