The larger trabeculae may display central necrosis imparting an acinar or pseudoglandular appearance. Individual cells are larger than normal hepatocytes with nuclear hyperchromasia, anisocytosis, multiple nucleoli and frequent and bizarre mitoses. Bile pigment may be present within the cytoplasm of tumor cells or within the canaliculi between cells. Vascular invasion may be prominent and metastases to lung and lymph nodes may occur. Clusters of these cells are separated by narrow to broad bands of laminated collagen.
Carcinoembryonic antigen is consistently absent in both forms of hepatocellular carcinoma.
An immunohistochemical study of nineteen cases and a review of the literature. Chawla A, Kahn E, Becker J, et al. A case of childhood hepatitis B virus infection related primary hepatocellular carcinoma with short malignant transformation time. Iwatsuki S, Starzl TE, Sheahan DG, et al. Hepatic resection versus transplantation for hepatocellular carcinoma.