Hepatocellular carcinoma pathophysiology
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Hepatocellular carcinoma Microchapters |
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Differentiating Hepatocellular carcinoma from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Hepatocellular carcinoma pathophysiology On the Web |
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American Roentgen Ray Society Images of Hepatocellular carcinoma pathophysiology |
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Risk calculators and risk factors for Hepatocellular carcinoma pathophysiology |
Overview
Hepatocellular carcinoma, like any other cancer, develops when there is a mutation to the cellular machinery that causes the cell to replicate at a higher rate and/or results in the cell avoiding apoptosis. In particular, chronic infections of Hepatitis B and/or C can aid the development of hepatocellular carcinoma by repeatedly causing the body's own immune system to attack the liver cells, some of which are infected by the virus, others merely bystanders. While this constant cycle of damage followed by repair can lead to mistakes during repair which in turn lead to carcinogenesis, this hypothesis is more applicable, at present, to Hepatitis C. In Hepatitis B, however, the integration of the viral genome into infected cells is the most consistently associated factor in malignancy. Alternatively, repeated consumption of large amounts of ethanol can have a similar effect. The toxin aflatoxin from certain Aspergillus species of fungus is a carcinogen and aids carcinogenesis of hepatocellular cancer by building up in the liver. The combined high prevalence of rates of aflaxtoxin and hepatitis B in countries like China and western Africa has led to relatively high rates of heptatocellular carcinoma in these regions. Other viral hepatitides such as hepatitis A have no potential to become a chronic infection and thus are not related to hepatocellular carcinoma.
Images
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Hepatocelluler carcinoma. The image shows a longitudinal slice taken through the full length of the liver.
(Courtesy of Ed Uthman, MD) -
The tumor is at the top, cirrhotic liver at the bottom, and a fibrous reaction in between. Hepatocellular carcinomas can have a variety of gross patterns, including multinodular / multifocal, such as this one.
(Courtesy of Ed Uthman, MD)
