Ground-glass cells in hepatocellular carcinoma

Hematoxylin and eosin-stained sections representing ten cases of hepatocellular carcinoma showed many tumor cells with ground-glass cytoplasm identical to that found in hepatocytes containing hepatitis B surface antigen (HBsAg). However, the aldehyde fuchsin stain was negative, as were the were the immunoperoxisidase stains for HBsAg and core antigen (HBcAg). Electron microscopically, the ground-glass appearance corresponded to the presence of non-membrane-bound amorphous or fibrillar inclusions. Immunohistochemically, the ground-glass material reacted with antiserum to human fibrinogen, suggesting synthesis of this protein by the carcinoma cells. Although the ground-glass appearance in hepatocellular carcinomas may sometimes be associated with HBsAg, special stains or technics are necessary to confirm its presence.