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Rastogi. Hepatoma Res 2020;6:47 Hepatoma Research
DOI: 10.20517/2394-5079.2020.35

Review Open Access

Pathomolecular characterization of HCC in non-
cirrhotic livers

Archana Rastogi

Department of Pathology, Institute of Liver & Biliary Sciences, New Delhi-110070, India.
Correspondence to: Prof. Archana Rastogi, Department of Pathology, Institute of Liver & Biliary Sciences, D-1, VASANT KUNJ,
New Delhi 110070, India. E-mail: drarchanarastogi@gmail.com

How to cite this article: Rastogi A. Pathomolecular characterization of HCC in non-cirrhotic livers. Hepatoma Res 2020;6:47.
http://dx.doi.org/10.20517/2394-5079.2020.35

Received: 13 Apr 2020 First Decision: 13 May 2020 Revised: 19 May 2020 Accepted: 26 May 2020 Published: 7 Aug 2020

Academic Editor: Dalbir Singh Sandhu Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Hepatocellular carcinoma (HCC) is the most common primary liver cancer and usually arises in cirrhotic
Received: First Decision: Revised: Accepted: Published: livers. Increasingly, it is diagnosed in non-cirrhotic livers. A variety of risk factors and etiologies can trigger the
development of HCC in non-fibrotic and non-cirrhotic backgrounds. The most important causes are metabolic
Science Editor: Copy Editor: Production Editor: Jing Yu syndrome and hepatitis B virus infection. Postulated pathogenetic mechanisms are direct carcinogenesis,
chronic liver injury and repair cycles, and genetic/epigenetic aberrations. Histopathology has a very important
role in the diagnosis of non-cirrhotic HCC. Gross features of non-cirrhotic HCC are quite different from HCC
originating in a cirrhotic background. Microscopic characteristics are similar to a classical HCC. However, certain
histological variants show a predilection to occur in non-cirrhotic livers. These encompass fibrolamellar, scirrhous,
steatohepatitic and mixed hepato-cholangiocarcinoma subtypes. Due to the non-cirrhotic background, adenoma,
metastasis and most of the other non-neoplastic and neoplastic conditions enter the differential diagnosis. Genomic
studies and morpho-molecular classifications of HCC provide further understanding of the molecular pathogenesis
of non-cirrhotic HCC. This group however, has rarely been exclusively studied. This review offers an update of
etiology, patho-molecular characteristics and differential diagnosis of HCC arising in non-cirrhotic backgrounds.

Keywords: Hepatocellular carcinoma, non-cirrhotic, etiopathogenesis, molecular genetics, pathology, patho-
molecular, differential diagnosis

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
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