Review of outside material. Although the routine hematoxylin and eosin appearance of the tumor suggests a metastatic carcinoma, the panel of immunocytochemical stains is most consistent with hepatocellular origin of the tumor. It is possible that this may represent an intrahepatic metastasis. The case has also be reviewed by Dr. Randall Lee who agrees with the interpretation of the special stains.
Clinical correlation is requested.
There is a core of hepatic parenchyma which shows portal inflammation of a mild to moderate degree. In addition there are several smaller fragments which also contain hepatocytes but additionally contain necrotic areas and areas of anaplastic epithelial cells. The cells assume an elliptical architecture, suggesting the possibility that they may be within vascular or lymphatic spaces, at least in areas. Nuclear membranes are thickened, rounded and slightly irregular. Nucleoli are prominent, single and central.