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Clinical history
59-year-old with cirrhosis under surveillance, 24 mm arterialised nodule.
Specimen
Core biopsy · Stain: H&E and reticulin
Microscopic description
Increased cell density with thickened trabeculae, reticulin loss, unpaired arteries and mild cytological atypia.
Diagnostic question
Which ancillary stains support the diagnosis?
Reveal differential diagnosis
High-grade dysplastic nodule
Focal nodular hyperplasia
Hepatocellular adenoma
Reveal final diagnosis
Well-differentiated hepatocellular carcinoma
Learning points
Reticulin loss is a key discriminator
Glypican-3, HSP70 and glutamine synthetase form a useful panel
Correlate with imaging and clinical context
Self-assessment
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All whole-slide images in this library are anonymised and used under appropriate licence. Cases are provided for education only and must not be used for clinical diagnosis.