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Abstract Details
Mimics of hepatocellular carcinoma: a review and an approach to avoiding histopathological diagnostic missteps
Hum Pathol. 2021 Jun;112:116-127. doi: 10.1016/j.humpath.2020.12.002.Epub 2020 Dec 18.
Dauod Arif1, Tetyana Mettler1, Oyedele A Adeyi2
Author information
1University of Minnesota Medical School, Department of Laboratory Medicine & Pathology, MN 55455, USA.
2University of Minnesota Medical School, Department of Laboratory Medicine & Pathology, MN 55455, USA. Electronic address: adeyio@umn.edu.
Abstract
Hepatocellular carcinoma (HCC) is one of the commonest carcinomas and leading causes of cancer-related death. Although, in patients with cirrhosis, radiologic diagnosis has improved significantly over the years, needle biopsy and histopathological assessment remains an important diagnostic modality. Most importantly, histopathological diagnosis is essential in patients with contending extrahepatic primaries, those with no known HCC risk factors, patients with ambiguous radiological features, and many other clinical contexts. Helpful features such as high serum alpha-fetoprotein (AFP) serologies are known to be present in many other tumor (including but not only HCC) and nontumor contexts and therefore not only lack sufficient diagnostic specificity for HCC but also create the potential to overlook non-HCC AFP-producing tumors, of which there are many. Therefore, using clinical examples and other examples from the medical literature, this review discusses several clinical and histological mimics of HCC and proffers an approach for practicing pathologists geared toward avoiding missteps.