Zusammenfassung
Die bioptische Diagnostik früher und hochdifferenzierter Lebertumoren zählt zu den anspruchsvollsten Fragestellungen der histopathologischen Diagnostik. Sie unterliegt in den letzten Jahren aufgrund veränderter klinischer Rahmenbedingunen einer erheblichen Dynamik. Zudem wurden neue Erkenntnisse zur molekularen Pathogenese in die Biopsiediagnostik dieser Läsionen integriert. Neben der Definition prognoserelevanter Subtypen des frühen hepatozellulären Karzinoms wurden morphologische Algorithmen und neue immunhistologische Marker zur Differenzialdiagnose hochdifferenzierter hepatozellulärer Tumoren entwickelt. Daneben wurde eine neue, prognostisch relevante, molekularpathologische und histologische Klassifikation des Leberzelladenoms erarbeitet. Durch die konsequente Anwendung dieser neuen diagnostischen Erkenntnisse und unter Einbeziehung der so genannten „Matrixdiagnostik“ gelingt heute bei fast allen hochdifferenzierten hepatozellulären Tumoren eine zuverlässige diagnostische Einstufung.
Abstract
Biopsy diagnosis of early and highly differentiated liver tumors is one of the most challenging tasks in histopathology. During recent years its parameters have changed fundamentally due to shifting clinical algorithms. Modern histopathology has met this challenge by defining new, prognostically relevant subtypes of early hepatocellular carcinoma and by elaborating morphological algorithms and novel immunohistological markers for the differential diagnosis of highly differentiated hepatocellular tumors. In addition, a new, predictive molecular pathological and histological classification of liver cell adenoma has been developed. By means of the consequent application of these new diagnostic tools, together with the so-called ‘matrix diagnosis’, a reliable diagnosis is achieved in the vast majority of these difficult cases.
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Schirmacher, P., Longerich, T. Hochdifferenzierte Lebertumoren. Pathologe 30 (Suppl 2), 200–206 (2009). https://doi.org/10.1007/s00292-009-1214-4
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DOI: https://doi.org/10.1007/s00292-009-1214-4