“Hello”(after the vacations)

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Liver tumorsBenign Malignant

Benign and Malignant

Most common Benign tumor

of Liver is

Cavernous hemangioma

Red Blue soft nodules

Less than 2 cms

Site – under the capsule

~ can be mistaken for metastasis

Liver cell adenoma

Benign

Common in :

Can rupture during pregnancy

Clinical significance :

Liver cell adenoma

Pale yellow nodule

Below the capsule

Can grow big

Liver cell adenoma

Sheets and cords of cells ,

Looks like normal liver

Portal tracts are absent

Malignant tumors

Most common are –

metastasis

Primary Sites :

Primary Malignant tumors

Hepatoblastoma

Angiosarcoma

Hepatocellular carcinoma (HCC)

Hepatoblastoma

In young people

Epithelial and mixed type

Angiosarcoma

Vinyl chloride,

Arsenic,

Thorotrast

… dacades of exposure

Fatal tumor

Hepatocellular Carcinoma

Global trends

Etiology

Viral infection

Alcohol Food Toxins

Hepatitis B

Hepatitis C

Tell some other Oncogenic viruses…

Epstein BarrBurkitt’s Lymphoma

Nasopharyngeal

carcinoma

Hepatocellular carcinoma

HBV

HCV

Cervix cancer

HPV 16,18

Human herpes virus 8

Kaposi’s sarcoma

B Cell Lymphoma

HTLV I Adult T Cell

leukemia lymphoma

What these viruses do ?

More cell cycles

Instable genome after the HBV DNA

Attachment

Aflatoxin (Aspergillus flavus)

Mutation of P53 gene

Clinical features

Upper abdominal pain, FatigueWeight loss

Raised serum Alfa feto pretein (~75 % patients)

Gross

Unifocal

Multifocal

Diffuse infiltrating

Microscopy :

Well differentiated to poor differentiated

Metastasis

In Lungs , Lymphnodes

Fibrolamellar type

Young people 20 – 40 yrNot associated with HBV

Single tumorGood prognosis

Some other liver Images

Identify !

Normal Liver cut section

Fatty Liver

Macronodular cirrhosis

Some good

Pathology websites

www.pathguy.com

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