A clinical and pathological study of diffuse type hepatocellular carcinoma

Area of Science:

• Hepatology
• Oncology
• Pathology

Background:

• Studied six autopsy cases of the rare, diffuse type of hepatocellular carcinoma (HCC).
• Diffuse HCC is defined anatomically by gross classification.
• This subtype presents with rapid clinical deterioration and liver failure.

Observation:

• Liver enlargement and abdominal pain were common clinical features.
• Diagnosis was challenging, requiring combined imaging (celiac angiography, scintiscan) and lab data.
• Hepatitis B surface antigen was positive in tested patients.

Findings:

• The entire liver showed numerous, uniformly sized tumor nodules, evenly distributed.
• Underlying cirrhosis with small regenerative nodules was present in all cases.
• Tumor thrombi in portal branches indicated intrahepatic spread via the portal vein system.

Implications:

• Diffuse HCC likely represents widespread intrahepatic portal metastases.
• The rapid progression suggests rapid dissemination within a short timeframe.
• Understanding this pattern is crucial for accurate diagnosis and management of HCC.