Skip to main content

Table 1 Clinicopathologic characteristic of fibrolamellar hepatocellular carcinoma in comparison to conventional hepatocellular carcinoma

From: Contemporary management of fibrolamellar hepatocellular carcinoma: diagnosis, treatment, outcome, prognostic factors, and recent developments

Characteristic FL-HCC HCC Comments
Age at presentation Young Older  
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  
Growth pattern Indolent Aggressive  
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  
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  
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
  1. FL-HCC fibrolamillar hepatocellular carcinoma, HCC conventional hepatocellular carcinoma