GPR: 2019 - Week 51

From MGH Learn Pathology

Clinical history

30-year-old female with a 6.6 cm liver mass


GPR19-41 -01 Fibrolamellar HCC.jpg


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GPR19-41 -01 Fibrolamellar HCC.jpg

 
Fibrolamellar hepatocellular carcinoma
  • Majority of tumors arise in the left lobe
  • Large and solitary
  • Often well-circumscribed
  • Lobulated with fibrous septae or central stellate scar
  • Pale brown, tan, or green in color
  • Firm/hard due to fibrous stroma
  • Background liver is non-cirrhotic
 

GPR19-41 -02 HCC.jpg

 

Hepatocellular carcinoma

  • Solitary, can have with satellite nodules or multiple discrete tumors
  • Soft, paler than normal liver tissue, can be bile-stained
  • Variable hemorrhage and necrosis
  • Can extensively involve large vessels (portal and hepatic veins, IVC)
  • Background liver is usually cirrhotic
 

GPR19-41 -03 ICC.jpg

 

Intrahepatic cholangiocarcinoma

  • Firm, irregular, white-tan fibrotic mass with infiltrative border
  • Usually arises in non-cirrhotic liver
  • Can be classified as three (3) subtypes.

1. Mass-forming: Most common, solid mass

2. Periductal infiltrating: Tumor grows along large bile ducts, can cause strictures

3. Intraductal: Tumor grows toward lumina of large bile ducts with papillary or polypoid growth
 

GPR19-41 -04 FNH.jpg

 

Focal nodular hyperplasia

  • Usually solitary (70-80%) and small (<5 cm)
  • Well-circumscribed, unencapsulated
  • Light tan-brown to yellow.
  • Central gray-white stellate scar with fibrous radiations (characteristic but not always present)
  • Usually arise in non-cirrhotic background
 
  • Dr. Andrew Crabbe
  • MGH Residents

This week's Gross Pathology Roundup was presented by Mingjuan Lisa Zhang, MD on Mon, Dec 16, 2019.