Liver and intrahepatic bile ducts - tumor
Hepatocellular carcinoma
Sclerosing variant

Topic Completed: 1 February 2012

Revised: 25 January 2019, last major update February 2012

Copyright: (c) 2002-2017,, Inc.

PubMed Search: Sclerosing hepatocellular carcinoma[TIAB]

Page views in 2018: 1,273
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Cite this page: Jain D. Sclerosing variant of hepatocellular carcinoma. website. Accessed February 21st, 2019.
Definition / general
  • Variant with fibrous septa separating trabecular cell plates but no lamellar fibrosis
  • Also called scirrhous carcinoma
  • May not be a distinct histopathologic entity
Clinical features
  • 1 - 4% of all hepatocellular carcinoma
  • Associated with hypercalcemia and hypophosphatemia but not with bone metastases
  • Better prognosis (Hepatogastroenterology 2009;56:1086)
Gross description
  • Single, subcapsular, unencapsulated, large, lobulated, gray white, firm, circumscribed mass, often with serrated border
  • Often satellite nodules
  • More diffuse fibrosis than fibrolamellar variant, no radiating fibrous bands, no central scar and usually no cirrhosis
  • Cirrhosis usually similar to classic HCC
Microscopic (histologic) description
  • Fibrous septa separate trabecular cell plates but no lamellar fibrosis
  • Cell plates 3 or more cells thick
  • Tumor cells may have pseudoglandular (acinar) features compared to fibrolamellar variant, are smaller, lack vesicular nuclei and prominent nucleoli and have less abundant and granular cytoplasm
  • No apparent endothelial sinusoidal cells
Positive stains
Negative stains
Differential diagnosis