Multicentric occurrence of hepatocellular carcinoma: In terms of pathology study
- 53 Downloads
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 wordshepatocellular carcinoma multicentric occurrence synchronous multicentric occurrence metachronous multicentric occurrence
Unable to display preview. Download preview PDF.
- 1.Majima Y, Tanikawa K (1991) Small liver cancer—clinical observations. In: Okudaira M, Mizumoto R, Tanikawa K (eds) Liver (in Japanese). Tokyo, Bunkodo, pp 35–43Google Scholar
- 2.Okuda K, Tanaka M, Nakayama T, Saitsu H, Tanikawa K, Nakashima O, Kojiro M (1993) Clinicopathologic comparison between resected hepatocellular carcinoma (HCC) and recurrent tumors. A special reference to multicentric carcinogenesis of HCC. Int Hepatol Comm 1:65–71Google Scholar
- 3.Kojiro M, Sugihara S, Nakashima O (1991) Pathomorphologic characteristics of early hepatocellular carcinoma. In: Okuda K, Tobe T, Kitagawa T (eds) Early detection and treatment of liver cancer. Gann monograph on cancer research. No. 38, Japan Scientific Societies Press, Tokyo, pp 29–38Google Scholar
- 6.Kennmochi K, Sugihara S, Kojiro M (1987) Relationship of histologic grade of hepatocellular carcinoma (HCC) to tumor size, and demonstration of tumor cells of multiple different grade in single HCC nodule. Liver 7:18–26Google Scholar
- 9.Eguchi A, Nakashima O, Okudaira S, Sugihara S, Kojiro M (1992) Adenomatous hyperplasia in the vicinity of small hepatocellular carcinoma. Hepatology 20:843–848Google Scholar
- 12.Liver cancer study group of Japan (1992) The general rules for the clinical and pathological study of primary liver cancer, 3rd edn (in Japanese). Tokyo, Kanehara ShuppanGoogle Scholar
- 13.Shimamatsu K, Kage M, Nakashima O, Kojiro M (1994) Pathomorphological study of HCV antibody-positive liver cirrhosis. J Gastroenterol Hepatol 9:623–630Google Scholar
- 14.Tarao K, Hoshino H, Shimizu A, Ohkawa S, Nakamura Y, Harada M, Ito Y, Tamai S, Akaike M, Sugimasa Y (1994) Role of increased DNA synthesis activity of hepatocytes in multicentric hepatocarcinogenesis in residual liver of hepatectomized cirrhotic patients with hepatocellular carcinoma. Jpn J Cancer Res 85:1040–1044PubMedGoogle Scholar
- 15.Nakashima O, Kojiro M (1994) Pathology of early hepatocellular cancinoma (in Japanese). Geka Chiryo 71:51–58Google Scholar
- 16.Hsu HC, Chiou TZ, Chen JY, Lee CS, Lee PH, Peng SY (1990) Clonality and clonal evolution of hepatocellular carcinoma with multiple nodules. Hepatology 13:923–928Google Scholar