Table 1.

Clinicopathologic characteristic of fibrolamellar hepatocellular carcinoma in comparison to conventional hepatocellular carcinoma

Characteristic	FL-HCC	HCC	Comments
Age at presentation	Young	Older
Sex predilection	No	4–8 times more often in men
Distinct geographic distribution	No	Yes	HCC is more often seen in Africa and Asia
Distribution of lesions	Mostly solitary	Mostly multiple
Growth pattern	Indolent	Aggressive
Stage at diagnosis	Mostly advanced	Mostly advanced	Despite the advanced stage at diagnosis, prognosis is in favor of FL-HCC patients
Chronic viral infection	Absent	Present
Liver cirrhosis	Absent	Present	Occasionally, underlying liver disease may be present in patients with FL-HCC. If present, incidental and not causative for FL-HCC
α-fetoprotein	Within normal range	Mostly elevated
Liver resection	Treatment of choice	Not standard	Limited indication in HCC due to cirrhosis
Liver transplantation	Not standard	Curative treatment	If requirements for LT are fulfilled
Prognosis	Favorable	Mostly dismal	No difference in non-cirrhotic patients
Macro-finding	Well-circumscribed, often lobulated mass, a central gray and white scare	Single or massive, multifocal or nodular, and diffuse. Due to lack of stroma in the tumor, often necrosis and hemorrhage
Histology	Eosinophilic polygonal-shaped cells separated by lamellar fibrosis. A fairly uniform cell pattern. Overall, greater differentiation than HCC	Thickened plates of hepatocytes with eosinophilic or clear cytoplasm. Cells are often arranged in trabecular, pseudoglandular, or solid pattern	Histologic appearances are the most objective and widely accepted differences between FL-HCC and HCC

FL-HCC fibrolamillar hepatocellular carcinoma, HCC conventional hepatocellular carcinoma