Table 3. . Findings at the microscope.
β-HCA/β-IHCA | Strong/diffuse (or patchy) GS-positive immunostaining and aberrant expression of β-catenin (can be very focal or absent) |
Clinical background | HCC in a context strongly suggestive of HCA |
Cellular and architectural atypia | Few foci of anisocaryosis or of smaller hepatocytes, thicker hepatocytic plates, decreased reticulin network, some pseudogland formations, cholestasis. Do not forget pitfall: vicinity of bleeding! |
Borderline HCA | Well-differentiated hepatocellular neoplasm: several foci of either atypia, rosettes, loss of reticulin, increased CD34 … but insufficient for a straightforward diagnosis of HCC |
HCC within HCA | One focus or several foci of HCC within an HCA, or rim of HCA surrounding HCC |
GS: Glutamine synthetase; HCA: Hepatocellular adenoma; HCC: Hepatocellular carcinoma; IHCA: Inflammatory hepatocellular adenoma.