Hepatocellular carcinoma (HCC) is the most common primary liver malignancy, frequently arising in the setting of chronic liver disease and cirrhosis. Advances in histopathologic classification have led to the recognition of various HCC subtypes, each with distinct morphologic, molecular, and clinical characteristics. This chapter provides an overview of the classification of cirrhotic nodules, including regenerative, dysplastic, and malignant nodules, and addresses the diagnostic challenges in distinguishing them. Prognostically significant subtypes of HCC, such as macrotrabecular-massive, clear cell, fibrolamellar, steatohepatitic, lymphocyte-rich, and sarcomatoid, are discussed, as well as the utility of ancillary immunohistochemical markers and emerging molecular markers that aid in diagnosis and prognostication. A comprehensive understanding of the histologic diversity of HCC is important for accurate diagnosis, subtyping, and effective patient management.

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Malignant Hepatocellular Tumors and Precursor Lesions

  • Monika Vyas,
  • Xuchen Zhang

摘要

Hepatocellular carcinoma (HCC) is the most common primary liver malignancy, frequently arising in the setting of chronic liver disease and cirrhosis. Advances in histopathologic classification have led to the recognition of various HCC subtypes, each with distinct morphologic, molecular, and clinical characteristics. This chapter provides an overview of the classification of cirrhotic nodules, including regenerative, dysplastic, and malignant nodules, and addresses the diagnostic challenges in distinguishing them. Prognostically significant subtypes of HCC, such as macrotrabecular-massive, clear cell, fibrolamellar, steatohepatitic, lymphocyte-rich, and sarcomatoid, are discussed, as well as the utility of ancillary immunohistochemical markers and emerging molecular markers that aid in diagnosis and prognostication. A comprehensive understanding of the histologic diversity of HCC is important for accurate diagnosis, subtyping, and effective patient management.