The number of granulomas and loosely arranged epithelioid cell foci in wedge liver biopsy specimens of 39 patients with primary biliary cirrhosis were counted and correlated with other hepatic lesions. Granulomas and cell foci were present in 76.9 and 87.2% of the patients, respectively; their numbers varied greatly from case to case (mean +/- S.D.: 2.4 +/- 3.4 per cm2 and 4.7 +/- 5.5 per cm2 of liver section; range: 0 to 18.5 per cm2 and 0 to 23.3 per cm2, respectively) and decreased as bile duct loss progressed. There was positive correlation between the number of cell foci with the extent of florid duct lesions, and negative correlation with hepatic fibrosis and deposition of copper granules.

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PubMedDate not supplied

Incidental solitary hepatocellular carcinomas smaller than 1 cm in size found at autopsy: a morphologic study.

The morphologic features and growth pattern of single hepatocellular carcinomas less than or equal to 1 cm in size, found incidentally at autopsy, were studied in nine cases. In all but one case, the hepatic parenchyma showed advanced cirrhosis. In three cases, the hepatocellular carcinomas were localized within a regenerative nodule as a form of "nodule within nodule." The carcinoma was rimmed by nonneoplastic hepatic tissue. A fourth carcinoma consisted of an expansile hepatocellular carcinoma nodule enclosed by a fibrous band of cirrhotic stroma. The remaining five cases consisted of hepatocellular carcinomas which infiltrated the surrounding regenerative nodules or hepatic lobules. These observations suggested that hepatocellular carcinomas arise within regenerative nodules, some of which still retain residual nonneoplastic tissue around the tumor. Others invaded the adjacent liver tissue. The grossly visible fibrous capsule, often seen in more advanced hepatocellular carcinomas, was absent in all cases. All of the hepatocellular carcinomas were well-differentiated. Four cases showed a trabecular pattern with slight sinusoidal dilatation, 3 showed a scirrhous pattern and 2 showed a compact pattern. Their histologic features included marked bile production, Mallory body formation by clusters of tumor cells, resistance to hemosiderin deposition in a markedly siderotic background and loss or decrease of reticulin fibers. These features were hallmarks of small hepatocellular carcinomas. Pathologists should study cirrhotic livers carefully so as not to miss small carcinomas. Clinicians should be aware that even small liver nodules may be hepatocellular carcinomas.

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PubMedDate not supplied

Resected case of hepatocellular carcinoma associated with lupoid hepatitis.

A 65 year old woman with lupoid hepatitis developed hepatocellular carcinoma which was diagnosed at an early stage. She had no history of blood transfusion and serum hepatitis B virus markers were negative. Prednisolone and 6-mercaptopurine were administered for the treatment of lupoid hepatitis. A hepatocellular carcinoma was detected by the elevation of serum alpha-fetoprotein and imaging studies. A tumour, 1.4 cm in diameter, was located in the lateral segment of the left hepatic lobe. It was resected by hepatic subsegmentectomy. Histological study showed a hepatocellular carcinoma of Edmondson type II against a background of posthepatitic cirrhosis. The patient was in good condition 2.5 years after the operation.

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