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Lo. Hepatoma Res 2019;5:41 Hepatoma Research
DOI: 10.20517/2394-5079.2019.021

Review Open Access

An update on the histological subtypes of
hepatocellular carcinoma

Regina Cheuk-Lam Lo 1,2

1 Department of Pathology, The University of Hong Kong, Hong Kong, China.
2 State Key Laboratory of Liver Research, The University of Hong Kong, Hong Kong, China.

Correspondence to: Regina Cheuk-Lam Lo, MBChB, FRCPA, FHKAM (Pathology), Department of Pathology, The University of Hong
Kong, Queen Mary Hospital, Pokfulam, Hong Kong SAR, China. E-mail: reginalo@pathology.hku.hk

How to cite this article: Lo RCL. An update on the histological subtypes of hepatocellular carcinoma. Hepatoma Res 2019;5:41.
http://dx.doi.org/10.20517/2394-5079.2019.021

Received: 18 Oct 2019 First Decision: 31 Oct 2019 Revised: 7 Nov 2019 Accepted: 11 Nov 2019 Published: 15 Nov 2019

Science Editor: Dalbir Sandhu Copy Editor: Jing-Wen Zhang Production Editor: Tian Zhang

Abstract
Hepatocellular carcinoma (HCC) is one of the top-ranking cancers worldwide and in Southeast Asia. The high
propensity for tumor recurrence, distant metastasis and chemoresistance remain major hurdles in the treatment
of HCC. With advances on genetics and genomics research, molecular targeted therapies are emerging as a
hope for better disease control. On the histological perspective, microscopic review of clinical samples has
led to subclassification of HCC and establishment of new entities. In this review, latest understanding on
macrotrabecular-massive HCC, steatohepatitic HCC, lymphocyte-rich HCC, scirrhous HCC, fibrolamellar
carcinoma and combined hepatocellular-cholangiocarcinoma will be discussed, emphasizing on the clinical
relevance of these pathological entities. Further delineation of the histological, immunohistochemical, molecular
and biological phenotypes of primary liver cancer would to further enhance an integrated morphological-molecular
classification that better predicts clinical outcome and guides clinical management.

Keywords: Liver cancer, subtype, histology

INTRODUCTION
Hepatocellular carcinoma (HCC) is the most common primary liver cancer. Microscopically, it is
characterized by thickened cell plates, malignant tumor cell cytology, capillarization of sinusoids and
evidence of invasion. Histological evaluation of HCC specimens plays a key role in tumor staging, and

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
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