Hepatocellular carcinoma with an unusual papillary vesicular appearance

A resected hepatocellular carcinoma with grossly papillary, whitish cut surfaces and 'vesicles' in a noncirrhotic but hepatitis B surface antigen positive liver is described. This appearance has not previously been reported in the literature. Such an unusual appearance may lead to an erroneous diagnosis by both surgeons and pathologists. Histological features and possible mechanisms for the unusual gross appearance are discussed.