Hepatocellular Carcinoma

This grade 4 HCC shows marked cellular pleomorphism with tumor giant cells, abnormal mitotic figures, and absence of trabecular architecture (a feature of well-differentiated tumors). The histologic grading of HCC is based on the nuclear features of tumor cells: Grade 1 tumor cells resemble non-neoplastic hepatocytes, with small round nuclei and little/no atypia. Grade 2 tumor cells have conspicuous nucleoli, hyperchromatism, and irregular nuclear membranes. Grades 3 & 4 tumor cells display increasing nuclear pleomorphism, which may result in anaplasia and giant tumor cells (a bad prognostic sign).