Fibrolamellar hepatocellular carcinoma: A case report of a resected with an electron microscopic and flow cytometric analysis

摘要

A resected case of fibrolamellar (FLC) and hepatocellular (HCC) combined carcinoma arising In a non‐cirrnotic liver of a 29 year old female is reported, Including results of the preoperative percutaneous aspiration biopsy, which suggested FLC, and postoperative electron microscopic and flow cytometric analysis. Sections of the resected massive tumor of the left lobe of the liver showed hepatocellular carcinoma accompanying the fibrolamellar carcinoma element which was composed of tumor cells with eosino‐philic granular cytoplasm and unique cytoplasmic vacuoles (pale bodies). Lamellar fibrosis was present in the stroma, while no macroscopic central scar was demonstrated. Electron microscopy showed typical features of FLC and flow cytometric ONA analysis indicated diploid ONA pattern with a low proliferation rate. A common HCC element with trabecular structure also existed at the periphery of the tumor. No apparent etiologic agent for the development of hepatic neoplasm was Indicated In the history of this patient. She had been without recurrence for about 3 years after extended left tobectomy, when local recurrence was revealed. The recurrence has been treated with chemoembolization and percutaneous ethanol infusion several times up till the present. This case reconfirms the importance of the pathological diagnosis of FLC to promote surgical intervent