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Vol. 30, No. 6, 2012
Issue release date: December 2012
Dig Dis 2012;30:574–579

Histopathological Diagnosis of Early HCC through Biopsy: Efficacy of Victoria Blue and Cytokeratin 7 Staining

Kobayashi S. · Kim S.R. · Imoto S. · Ando K. · Hirakawa M. · Saito J. · Fukuda K. · Otono Y. · Sakaki M. · Tsuchida S. · Kim S.K. · Hayashi Y. · Nakano M. · Kudo M.
aDepartment of Hepatology, Osaka City University Graduate School of Medicine, Osaka, bDepartment of Gastroenterology, Kobe Asahi Hospital, cDivision of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, and dDivision for Infectious Disease Pathology, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, eDepartment of Gastroenterology, Kyoto University, Kyoto, fDivision of Pathology, Ohfuna Chuo Hospital, Kamakura, and gDepartment of Gastroenterology and Hepatology, Kinki University School of Medicine, Osaka-Sayama, Japan

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Objectives and Methods: Findings of histological analyses of 2 cases of liver biopsy revealing hypovascular nodules are described. Results: Ultrasound examination revealed hypovascular and hypoechoic nodules (8 mm in diameter) in segment 1 (case 1) and (8 mm) in segment 8 (case 2). The nodules were detected by only Gd-EOB-DTPA-enhanced MRI. Hematoxylin and eosin staining of ultrasound-guided biopsy of the nodules revealed slight hypercellularity without the features of early hepatocellular carcinoma (HCC) such as cell atypia, fatty change and pseudoglandular formation. Early HCC was suspected; however, Victoria blue staining disclosed terminal portal tract invasion, the most important finding of early HCC. Also, cytokeratin 7 staining revealed decreased ductular reaction compatible with early HCC. Taken together, these histological analyses confirmed the two nodules to be early HCC. Conclusion: Based on the criteria of the International Consensus Group, the two nodules were diagnosed as early HCC through biopsy.

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