Four pressing problems in liver pathology

Four important challenges in liver pathology are explored. Recognizing challenges in diagnostic pathology is one of the most important ways the field grows and improves, and this is reflected in the four challenges selected for review. The first problem considers the best approach to low-grade hepatocellular lesions in livers with chronic vascular disease. The second problem addresses the difficulties in making a diagnosis of portal vein disease and in choosing the best nomenclature. Problem 3 focuses on best practices for primary carcinomas of the liver that are difficult to classify as hepatocellular carcinoma versus cholangiocarcinoma. Problem 4 discusses the good and the bad of ongoing efforts to change established names of disease entities. All of these problems are discussed in their historical contexts and emphasize the practical aspects relevant to surgical pathology.