HCC - Proposed classification by International consensus group on HCC & WHO
PROGRESSED HCC (DISTINCTLY NODULAR ):
Majority are moderately differentiated with distinct margins
1. Ability to invade vessels & metastasize
2. Moderately Differentiated < 2 cm
2. Bigger size (> 2 cm)
3. Well marginated - surrounded by tumor capsule & contain internal septations
4. Propensity to portal vein invasion
5. Hypervascular
6. Show intra-hepatic metastasis
7. Predominantly unpaired arteries
Macrosocpic Subtypes:
- Nodular: encapsulated
- Multinodular: Aggregation of multiple small nodular type
- Massive : Large tumor with irregular demarcation
- Mosaic Architecture: tumor nodules separated by fibrous septations, hemorrhage, necrosis or fatty metamorphosis.
- Pedunculated / Protruded: Grows extrahepatically with or without a peduncle
MULTIFOCAL (overlap of terminology):
- Tumor nodules separated by intervening non-neoplastic parenchyma.
- Multicentric: synchronous development of multiple interdependent tumors
- Intrahepatic metastasis"
- Cirrhotomimetic / infiltrative : Cirrhotic like HCC or confluent multinodular with a "macroscopic appearance of innumerable permeating tumor nodules that resemble cirrhosis".
It can evade clinical and imaging. Usually poorly differentiated or undifferentiated
-Diffuse
Prepared by Dr. Sharad Maheshwari
31.07.2023
Updated:
References:
1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7907961/
3. https://pubs.rsna.org/doi/epdf/10.1148/radiol.14132361
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