Hepatobiliary System and Exocrine Pancreas

Focal nodular hyperplasia

Gross appearances of focal nodular hyperplasia. The resemblance to cirrhosis is striking.


Typical star-shaped central scar of radial shape in nodular hyperplasia. The lesion has a brownish cast
Focal nodular hyperplasia


Central portion of nodular hyperplasia showing the interphase between the fibrous scar and the hepatocytic nodules.
Focal nodular hyperplasia

It is larger than surrounding cirrhotic nodules but do not display atypical features.

Large macroregenerative nodule in a cirrhotic liver.

This is a benign hemangioma of the liver just beneath the capsule. Perhaps one person in 50 has such a neoplasm, which is typically just an incidental finding, since most are 1 cm or less. They can sometimes be multiple
Cavernous hemangioma liver



variably sized vascular spaces lined by flat endothelial cells and set within a fibrous stroma 
Cavernous hemangioma liver

Liver cell adenoma

Resected specimen presenting as a pendulous mass arising from the liver.
a
Surgically resected specimen showing a discrete mass underneath the liver capsule


Gross appearance of liver cell adenoma. The tumor, which is well circumscribed, has a large, central area of recent hemorrhage.
Liver cell adenoma

Broad cords of liver cells with prominent blood vessels (arrows)

Liver cell adenoma


The cancer is unifocal, massive type. A large neoplasm has replaced most of the right hepatic lobe in this noncirrhotic liver. A satellite nodule of cancer is seen in the vicinity of the main mass (arrow)
Hepatocellular carcinoma

Note the trabecular pattern of growth, nuclear atypicality, and bile production by tumor cells (Arrows). The broad trabeculae are separated by sinusoides
Hepatocellular carcinoma
Tubular formations in hepatocellular carcinoma (pseudoglandular HCC). These should not be interpreted as evidence of a cholangiocarcinomatous component. Note the separating sinusoids.



A, Resected specimen with an outer rim of normal liver. B, Nests and cords of tumor cells separated by dense bundles of collagen.
Fibrolamellar carcinoma

Hepatic metastases

Multiple hepatic metastases from a primary colon adenocarcinoma.

There are numerous variably sized whitish nodules. Some of the larger ones demonstrate central necrosis (umblication) (arrows). The masses are metastases to the liver.
Metastases to the liver


Liver metastases from an adenocarcinoma primary in the colon, one of the most common primary sites for metastatic adenocarcinoma in liver.
Liver metastases


Metastatic infiltrating ductal carcinoma from breast is seen on the right, with normal liver parenchyma on the left.
Liver metastases