[Detection and differentiation of atypical hepatocellular carcinomas]

Hepatocellular carcinoma (HCC) is a histologically heterogeneous tumor entity. According to the current World Health Organization (WHO) classification in addition to not otherwise specified (NOS) HCCs it is comprised of eight subtypes: steatohepatitic, clear cell, macrotrabecular massive, scirrous, chromophobe, fibrolamellar, granulocyte-rich and lymphocyte-rich. The HCC diagnosis is based on typical contrast agent behavior with arterial hyperenhancement followed by washout; however, HCC subtypes can show additional imaging features related to their histology. In addition, the HCC subtypes can partially differ from NOS HCC in aggressiveness and prognosis. Characterizing the various HCC subtypes could enable individualized treatment in the future and thus potentially influence the prognosis, even though a subtype-specific treatment for HCC subtypes apart from in studies is not currently available.