HCC Part 3: Hepatocarcinogenesis: Pathologic changes

 HCC Part 3: Hepatocarcinogenesis: Pathologic changes

                         Adapted from Radiology article by Jin-Young Choi  etal 

                                                          https://doi.org/10.1148/radiol.14132361

Fig. During hepatocarcinogenesis, the portal triads diminish while the density of unpaired arteries increases

- Hepatocarcinogenesis is a multi-step process that happens typically in cirrhosis

- It involves progressive differentiation of phenotypically abnormal nodular lesions

- It starts with less differentiated clonal populations manifesting as subnodules within the parent nodule (dysplastic foci)

- Over the time it replaces more differentiated areas within the entire nodule. 

- Progressed HCC: represent expansile growth, unpaired arteries and are encapsulated with fibrous septa.  

- The process can simultaneously happens in multiple areas in the liver (multicentric hepatocarcinogenesis)

- "de novo hepatocarcinogenesis" - typically happens in non-cirrhotic livers without identifiable histologic precursors. 

Prepared by Dr. Sharad Maheshwari

24.7.2023

References: https://pubs.rsna.org/doi/full/10.1148/radiol.14132361