GPR: 2021 - Week 10

From MGH Learn Pathology

Clinical history

84 yo man with a 4.3 cm liver mass


GPR21-7-79216b52-b826-4d54-bf6e-0dd976390dda.jpeg


Registered users must be logged in to access the interactive quiz.


GPR21-7-79216b52-b826-4d54-bf6e-0dd976390dda.jpeg

 
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
 

GPR21-7-846527d4-107f-493a-b2ba-5ee47c096bd7.jpeg

 

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
 

GPR21-7-872701eb-b750-43d3-a65f-62b177c2fbe4.jpeg

 

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
 

GPR21-7-4f1c89b9-2cd8-4e41-8b52-f1a684c8ed0f.jpeg

 

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.