Histopathological Diagnosis of Early HCC through Biopsy: Efficacy of Victoria Blue and Cytokeratin 7 Staining

Objectives and Methods: Findings of histological analyses of 2 cases of liver biopsy revealing hypovascular nodules are described. Results: Ultrasound examination revealed hypovascular and hypoechoic nodules (8 mm in diameter) in segment 1 (case 1) and (8 mm) in segment 8 (case 2). The nodules were detected by only Gd-EOB-DTPA-enhanced MRI. Hematoxylin and eosin staining of ultrasound-guided biopsy of the nodules revealed slight hypercellularity without the features of early hepatocellular carcinoma (HCC) such as cell atypia, fatty change and pseudoglandular formation. Early HCC was suspected; however, Victoria blue staining disclosed terminal portal tract invasion, the most important finding of early HCC. Also, cytokeratin 7 staining revealed decreased ductular reaction compatible with early HCC. Taken together, these histological analyses confirmed the two nodules to be early HCC. Conclusion: Based on the criteria of the International Consensus Group, the two nodules were diagnosed as early HCC through biopsy.

[1]  J. Ricke,et al.  Noninvasive Diagnosis of Hepatocellular Carcinoma in Cirrhotic Liver: Current Guidelines and Future Prospects for Radiological Imaging , 2012, Liver Cancer.

[2]  Ijin Joo,et al.  Recent Advances in CT and MR Imaging for Evaluation of Hepatocellular Carcinoma , 2012, Liver Cancer.

[3]  M. Kudo,et al.  Diagnostic sensitivity of imaging modalities for hepatocellular carcinoma smaller than 2 cm. , 2010, World journal of gastroenterology.

[4]  V. Desmet.  East–West pathology agreement on precancerous liver lesions and early hepatocellular carcinoma , 2009, Hepatology.

[5]  Michiie Sakamoto,et al.  Pathologic diagnosis of early hepatocellular carcinoma: A report of the international consensus group for hepatocellular neoplasia , 2009, Hepatology.

[6]  T. Schiano,et al.  A patient with no known liver disease presenting with a sentinel variceal hemorrhage , 2009, Hepatology.

[7]  Neil D Theise,et al.  Hepatic precancerous lesions and small hepatocellular carcinoma. , 2007, Gastroenterology clinics of North America.

[8]  F. Kondo,et al.  Ductular reaction is helpful in defining early stromal invasion, small hepatocellular carcinomas, and dysplastic nodules , 2007, Cancer.

[9]  P. Hytiroglou,et al.  Morphological changes of early human hepatocarcinogenesis. , 2004, Seminars in liver disease.

[10]  I. Wanless,et al.  Terminology of nodular hepatocellular lesions , 1995 .

[11]  F. Callea,et al.  Pathology of hepatocellular carcinoma , 1993, Journal of surgical oncology. Supplement.