Related Experiment Video
Updated: Aug 7, 2026
A Three-Dimensional Spheroid Model to Investigate the Tumor-Stromal Interaction in Hepatocellular Carcinoma
Published on: September 30, 2021
[Diagnosis and differential diagnosis of hepatocellular carcinoma]
1Institut für Pathologie der Universität zu Köln, Joseph-Stelzmann-Strasse 9, 50931, Köln. u.drebber@uni-koeln.de
Insights
Hepatocellular carcinoma (HCC) incidence is rising due to chronic hepatitis C-induced cirrhosis. Accurate diagnosis requires identifying cirrhosis and differentiating HCC subtypes and other liver tumors.
Area of Science:
- Hepatobiliary pathology
- Oncology
- Gastroenterology
Context:
- Rising incidence of hepatocellular carcinoma (HCC) projected for the next decade.
- Chronic hepatitis C-induced cirrhosis is a primary driver, with a significant latency period.
- Accurate diagnosis of underlying cirrhosis is critical for patient management.
Purpose:
- To detail the diagnostic importance of underlying cirrhosis in hepatocellular carcinoma (HCC).
- To outline the diverse histological and cytological subtypes of HCC according to WHO guidelines.
- To discuss differential diagnoses, including hepatic adenomas, dysplastic nodules, mesenchymal tumors, and liver metastases.
Summary:
- Hepatocellular carcinoma (HCC) presents with various subtypes (trabecular, pseudoglandular, etc.) and cytological appearances (pleomorphic, clear cell, sarcomatous).
- Intracytoplasmic inclusions in tumor cells can aid HCC diagnosis.
- Distinguishing HCC from other hepatic tumors and metastases, particularly gastrointestinal tract primaries, is crucial.
Impact:
- Emphasizes the role of cirrhosis in HCC diagnosis.
- Highlights the utility of available antibodies for confirming diagnoses.
- Aids clinicians in differentiating complex liver tumor cases for improved patient outcomes.
Abstract:
The incidence of hepatocellular carcinoma (HCC) will continue to increase for the next decade due to a latency of about 30 years due to cirrhosis caused by chronic hepatitis C. The diagnosis of an underlying cirrhosis is of diagnostic importance. According to WHO guidelines, HCC encompasses the following: trabecular, pseudoglandular, acinar, compact, scirrhous and fibrolamellar subtypes. Cytological appearance includes hepatocellular pleomorphic, clear cell and sarcomatous subtypes. Tumor cells in hepatocellular carcinoma may display intracytoplasmic inclusions that are helpful for establishing the diagnosis. Differential diagnosis has to be considered for such hepatic tumors as adenoma and precancerous lesions such as dysplastic nodules or mesenchymal tumors. Metastases in the liver may be difficult to differentiate, especially for primary tumors from the gastrointestinal tract which may be similar to glandular or scirrhous type of HCC. The existence of underlying cirrhosis is helpful for the diagnosis and an ample spectrum of antibodies against liver antigens and adenocarcinomas are commercially available to confirm the correct diagnosis.
