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NEOPLASMS
Normal liver tissue with a portal tract is seen on the left. The hepatic adenoma is on the right and is
composed of cells that closely resemble normal hepatocytes, but the neoplastic liver tissue is disorganized
hepatocyte cords and does not contain a normal lobular architecture.
Here is an hepatocellular carcinoma. Such liver cancers arise in the setting of cirrhosis. Worldwide, viral
hepatitis is the most common cause, but in the U.S., chronic alcoholism is the most common cause. The neoplasm
is large and bulky and has a greenish cast because it contains bile. To the right of the main mass are smaller
satellite nodules.
The satellite nodules of this hepatocellular carcinoma represent either intrahepatic spread of the tumor or
multicentric origin of the tumor.
Here is another hepatocellular carcinoma with a greenish yellow hue. One clue to the presence of such a
neoplasm is an elevated serum alpha-fetoprotein. Such masses may also focally obstruct the biliary tract and
lead to an elevated alkaline phosphatase.
The malignant cells of this hepatocellular carcinoma (seen mostly on the right) are well differentiated and
interdigitate with normal, larger hepatocytes (seen mostly at the left).
Note that this hepatocellular carcinoma is composed of liver cords that are much wider than the normal liver
plate that is two cells thick. There is no discernable normal lobular architecture, though vascular structures
are present.
The carcinoma at the left has a glandular appearance that is most consistent with a cholangiocarcinoma.
A liver cancer may have both hepatocellular as well as cholangiolar differentiation. Cholangiocarcinomas do not
make bile, but the cells do make mucin, and they can be almost impossible to distinguish from metastatic
adenocarcinoma on biopsy or fine needle aspirate.
Here are liver metastases from an adenocarcinoma primary in the colon, one of the most common primary sites for
metastatic adenocarcinoma to the liver.
Microscopically, metastatic infiltrating ductal carcinoma from breast is seen on the right, with normal liver
parenchyma on the left.
The cut surface of the liver reveals the hepatic adenoma. Note how well circumscribed it is. The remaining
liver is a pale yellow brown because of fatty change from chronic alcoholism.
At the upper right is a well-circumscribed neoplasm that is arising in liver. This is an hepatic adenoma.
НАПИСАТЬ
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