Clinicopathological Analysis of Multicentric Hepatocellular Carcinoma in Cases with the Resected Multinodular Tumors

Masanori Matsuda, Masayuki Yamamoto, Masatoshi Mogaki, Jun Itakura, Yoshiro Matsumoto

First Department of Surgery, Yamanashi Medical College

Multicentric occurrence of hepatocellular carcinoma (HCC) has come to our attention. The multicentricity was diagnosed by histological examination as follows: 1. multiple relatively small well-differentiated HCC (SW-D HCC); 2. SW-D HCC combined with larger and less differentiated HCC; 3. multiple HCC showing a "nodule-in-nodule" appearance with an HCC of poorer differentiation within well-differentiated HCC (NN-HCC), or NN-HCC combined with another HCC. Among 45 HCC cases with intrahepatic multinodular lesions 10 (22.2%) were diagnosed as cases with multicentric HCC (MC). Three of them were accompanied by intrahepatic metastases. Histological capsular infiltration (75.0%) and portal vein invasion (56.3%) were frequent in the main lesions of the cases with only intrahepatic metastatic lesions (IM), but they were less detected (14.3%, 0% respectively) in 7 MC cases without intrahepatic metastasis. Non-cancerous liver of 6 MC cases (60.0%) showed chronic hepatitis, while this histological finding was recognized only 5 (15.6%) cases in IM group. There is no close correlation with hepatitis B and/or C virus infection in either group. Flow cytometric analyses were performed in 5 MC cases. DNA indices of the main lesion and the sublesion revealed a difference in 2 of 5 cases.

Key words
hepatocellular carcinoma, multicentric occurrence, intrahepatic metastasis, flow cytometry, DNA index

Reprint requests
Masanori Matsuda First Department of Surgery, Yamanashi Medical College
Tamaho-machi, Nakakoma, Yamanashi, 409-38 JAPAN

Accepted
November 20, 1991

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