Skip to main content

Intranodular Hemodynamic Transition Associated with Dedifferentiation of Hepatocellular Carcinoma

  • Chapter
  • 85 Accesses

Abstract

Hepatocellular carcinomas (HCC) evolve from hyperplastic lesions (hyperplastic foci, dysplastic nodules, or adenomatous hyperplasia) and develop into classic HCC via a multistep process.1–3 What changes occur in intranodular hemodynamics during this process? The answer has been gradually clarified through detailed comparative studies of blood flow images in which there are pathological findings.3 As shown in Fig. 3–1, hyperplastic lesions that arise from liver cirrhosis invariably present a type I vascular structure, in which the arterial blood flow is hypovascular and portal flow is preserved.4–6 In terms of histopathology, about 30% of type I cases resemble well-differentiated HCC.7,8 With cancer progression and dedifferentiation, both arterial and portal blood supplies decrease (type II). Thereafter, with arterial neovascularization within the tumor, intranodular hemodynamics transforms to type III, and then to type IV of classic HCC.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   54.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Kojiro M, Sugihara S, Nakashima O: Pathomorphologic characteristics of early hepatocellular carcinoma. In: Okuda K, Tobe T, Kitagawa T, eds, Early detection and treatment of liver cancer. Gann Monogr Cancer Res 1991; 38:29–372

    Google Scholar 

  2. Sakamoto M, Hirohashi S, Shimosato Y: Early stage of multistep hepatocarcinogenesis: adenomatous hyperplasia and early hepatocellular carcinoma. Hum Pathol 1991; 22:172–178

    Article  PubMed  CAS  Google Scholar 

  3. Choi BI, Takayasu K, Han MC: Small hepatocellular carcinomas and associated nodular lesions of the liver: pathology, pathogenesis, and imaging findings. AJR 1993; 160:1177–1187

    PubMed  CAS  Google Scholar 

  4. Kudo M, Tomita S, Kashida H, et al: Tumor hemodynamics in hepatic nodules associated with liver cirrhosis: relationship between cancer progression and tumor hemodynamic change. Jpn J Gastroenterol 1991; 88:1554–1565

    CAS  Google Scholar 

  5. Kudo M, Tomita S, Tochio H, et al: Hemodynamic characteristics of early stage hepatocellular carcinoma: in vivo evaluation with vascular imagings. Acta Hepatol Jpn 1992; 33:283–291

    Article  Google Scholar 

  6. Sasaki K: Adenomatous hyperplasia in liver cirrhosis: an approach from a microangiographical point of view. Gann Monogr Cancer Res 1980; 25:127–140

    Google Scholar 

  7. Kudo M: Morphological diagnosis of hepatocellular carcinoma: special emphasis on intranodular hemodynamic imaging. Hepato-Gastroenterology 1998; 45:1226–1231

    PubMed  Google Scholar 

  8. Kudo M: Imaging diagnosis of hepatocellular carcinoma and premalignant /borderline lesions. Semin Liver Dis 1999; 19:297–309

    Article  PubMed  CAS  Google Scholar 

  9. Kudo M: Imaging blood flow characteristics of hepatocellular carcinoma. Oncology 2002; 62(Suppl l):48–56

    Article  PubMed  Google Scholar 

  10. Kutami R, Nakashima Y, Nakashima O, et al: Pathomorphologic study on the mechanism of fatty change in small hepatocellular carcinoma of humans. J Hepatol 2000; 33:282–289

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 2003 Springer Japan

About this chapter

Cite this chapter

Kudo, M. (2003). Intranodular Hemodynamic Transition Associated with Dedifferentiation of Hepatocellular Carcinoma. In: Contrast Harmonic Imaging in the Diagnosis and Treatment of Hepatic Tumors. Springer, Tokyo. https://doi.org/10.1007/978-4-431-65904-4_3

Download citation

  • DOI: https://doi.org/10.1007/978-4-431-65904-4_3

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-65906-8

  • Online ISBN: 978-4-431-65904-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics