Table 1 Clinicopathologic characteristic of fibrolamellar hepatocellular carcinoma in comparison to conventional hepatocellular carcinoma
Characteristic | FL-HCC | HCC | Comments |
|---|---|---|---|
Age at presentation | Young | Older | Â |
Sex predilection | No | 4–8 times more often in men |  |
Distinct geographic distribution | No | Yes | HCC is more often seen in Africa and Asia |
Distribution of lesions | Mostly solitary | Mostly multiple | Â |
Growth pattern | Indolent | Aggressive | Â |
Stage at diagnosis | Mostly advanced | Mostly advanced | Despite the advanced stage at diagnosis, prognosis is in favor of FL-HCC patients |
Chronic viral infection | Absent | Present | Â |
Liver cirrhosis | Absent | Present | Occasionally, underlying liver disease may be present in patients with FL-HCC. If present, incidental and not causative for FL-HCC |
α-fetoprotein | Within normal range | Mostly elevated |  |
Liver resection | Treatment of choice | Not standard | Limited indication in HCC due to cirrhosis |
Liver transplantation | Not standard | Curative treatment | If requirements for LT are fulfilled |
Prognosis | Favorable | Mostly dismal | No difference in non-cirrhotic patients |
Macro-finding | Well-circumscribed, often lobulated mass, a central gray and white scare | Single or massive, multifocal or nodular, and diffuse. Due to lack of stroma in the tumor, often necrosis and hemorrhage | Â |
Histology | Eosinophilic polygonal-shaped cells separated by lamellar fibrosis. A fairly uniform cell pattern. Overall, greater differentiation than HCC | Thickened plates of hepatocytes with eosinophilic or clear cytoplasm. Cells are often arranged in trabecular, pseudoglandular, or solid pattern | Histologic appearances are the most objective and widely accepted differences between FL-HCC and HCC |