Journal of Hepato-Biliary-Pancreatic Surgery

, Volume 3, Issue 4, pp 442–446 | Cite as

Multicentric occurrence of hepatocellular carcinoma: In terms of pathology study

  • Masamichi Kojiro
  • Osamu Nakashima
Basic Knowledge of Interest


The remarkable advances in diagnostic techniques and in the pathomorphologic study of minute hepatocellular carcinomas (HCCs) in the early stage indicate that many HCCs are multicentric in origin. Morphologically, combinations of HCC nodules and other nodules, such as adenomatous hyperplasia containing cancerous foci, well-differentiated HCC, or well-differentiated HCC containing moderate or poorly differentiated cancerous tissue are considered to originate and proliferate in situ. These combinations are considered to be HCC of synchronous multicentric origin. We found that, in HCC associated with liver cirrhosis, 6 of 74 consecutively resected HCCs (8.3%) and 4 of 8 autopsy cases (50%) satisfied the above criteria for multicentric origin. This discrepancy between surgical and autopsy cases can be explained thus: In surgical cases, morphologic examination is limited to only the vicinity of the main tumor and patients with multiple minute tumors HCC tend not to be sent to the operation table. Thus, the frequency seen in autopsy cases may reflect the true figures for multicentric origin. In 94 HCCs associated with chronic hepatitis, we found none showing coexistence of the above nodules that are suggestive of synchronous multicentric origin.

Key words

hepatocellular carcinoma multicentric occurrence synchronous multicentric occurrence metachronous multicentric occurrence 


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Copyright information

© Springer-Verlag 1996

Authors and Affiliations

  • Masamichi Kojiro
    • 1
  • Osamu Nakashima
    • 1
  1. 1.First Department of PathologyKurume University School of MedicineKurumeJapan

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