GPR: 2021 - Week 10

From MGH Learn Pathology

Clinical history

84 yo man with a 4.3 cm liver mass


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Intrahepatic cholangiocarcinoma
  • Well-demarcated, non-encapsulated
  • Firm (due to desmoplastic reaction), white-tan to gray, nodular mass
  • Satellite nodules present in 30% of cases
  • Most cases have noncirrhotic background liver
  • 3 types: mass forming, periductal infiltrating, or intraductal growth



Hepatocellular carcinoma

  • Well-circumscribed, encapsulated in 50%
  • Tan-yellow to green, depending on fat and bile content
  • Solitary nodule, or dominant nodule with multiple satellite nodules
  • Background liver is usually cirrhotic
  • Commonly areas of hemorrhage and necrosis



Focal nodular hyperplasia

  • Well-demarcated, unencapsulated
  • Solitary lesion, but may be multifocal
  • Nodular appearance, lighter in color than surrounding liver parenchyma
  • Cut surface has characteristic central scar with radiating fibrous septae
  • Often located in subcapsular region



Metastatic carcinoma

  • 90% are multiple lesions
  • Variable sizes
  • Often hemorrhage and necrosis
  • Cannot determine malignancy based on gross appearance alone
  • Liana Bonanno
  • Chris Mount
  • Justin Susterich

This week's Gross Pathology Roundup was presented by Lisa Yuen, MD, PhD on Mon, Mar 08, 2021.