[Pathogenesis and morphology of hepatocellular carcinoma]

Hepatocellular carcinoma (carcinoma hepatocellulare) kills about 1.25 million of people a year all over the world and makes 1.5% of all malignant neoplasms. Many factors play a role in etiology of hepatocellular cancer; the most important seem to be: hepatitis B and C viruses, alcohol and aflatoxin exposure. They all can cause hepatic cirrhosis. In present days, however, it is assumed that all diseases which lead to hepatic cirrhosis may be complicated by growth of primary liver cancer, but degree of risk of its development is various. Hepatocellular carcinoma grows in three macroscopic forms: nodular (multifocal), massive (unifocal) and diffusely infiltrative. Its varying microscopic pattern has resulted in separating four major types: trabecular, pseudoglandular, solid and scirrhous. Immunohistochemical analysis of hepatocellular carcinoma plays an important role in practical diagnosis. Metastatic tumors of the liver (breast, pancreas, kidney and adrenal gland cancers) are more common than primary ones. In routine histological examination they may imitate primary hepatic cancer. Precise diagnosis is of vital importance for therapy and prognosis.