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Discuss hepatocellular carcinoma

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1Discuss hepatocellular carcinoma Empty Discuss hepatocellular carcinoma on Sun Apr 01, 2012 12:51 am

ismipahmie

ismipahmie
Star Member
Star Member

Definition : primary malignant neoplastic tumor arising from liver cell


Aetiology : The exact aetiology is unknown but those are predisposing factor

Age : usually above 40

Sex : Male is more common than female

Predisposing factor :

1. Cirrhosis, particularly macronodular

2. Chronic hepatitis B or C

3. Aflatoxins, derived from Aspergillus flavus fungus contaminating moldy grains and peanuts


Pathology

Sites liver

Gross

1. A large solitary tumor

2. Multicentric nodule (multinodular) pattern, multiple nodular tumor

3. Diffuse, the whole liver is almos entirely infiltrated by the tumor

Microscopy

1. Pleomorphism, increase N/C ratio, prominent nucleoli, abnormal mitotic figure, anaplasia

2. Arranged in trabecular or acinar pattern, separated by little vascular stroma

3. Fibrolamellar carcinoma(rare) :large eosinophilic hepatocytes, separated by parallel bundles of collagen


Effect

Spread

i)Direct : liver

ii) Lymphatic : to hilar lymph node

iii) Blood : through hepatic veins to lungs then other organs

through portal veins leading metastasis in liver itself


complication

1. Haemorrhage

2. Secondary infection

3. Liver failure( loss of function)

4. Hepatomegaly

5. Jaundice

6. Portal vein thrombosis

7. Ascites

8. Elevation of serum alpha fetoprotein

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