Studies of Primary Liver Carcinoma.

NAKASHIMA Toshiro, KOJIRO Masamichi, SAKAMOTO Kazuyoshi, OKUDA Kunio, SHIMOKAWA Yutaka, KUBO Yasuhiko

doi:10.2957/kanzo.15.279

Because of the recent advances in the diagnosis and treatment of primary liver carcinoma, clinical assessment of gross pathology with respect to size, location and speed of expansion, and judgement of the presence or absence of cirrhosis are now mandatory. The gross anatomical classification of primary liver carcinoma in the past has been that of Eggel, which subdivides it into three groups of 1) the diffuse, 2) the nodular, and 3) the massive type. It is too illdefined and unsatisfactory in view of the varigated gross features of hepatoma. This study was undertaken to develop a more clearly defined classification with a view to serving in early selection of therapeutic measure.<BR>The material for study consisted of 112 hepatoma livers that have been inspected with cut sections across the entire organ. Cholangiomas have been excluded. Our classification is more based on the status of boundary between parenchyma and tumor, and on the spread, rather than on the mass size, with clinical characteristics such as angiographic alterations in mind. In this classification, the diffuse type is further subdivided into the "diffuse" and "fine-nodular diffuse, " the nodular type into the "multinodular, " "cirrhotic oligo-nodular, " "encapsulated" and "massive nodular, " and the massive type into the "solitary massive" and "confluent massive". Thus, 8 distinctly different types have been proposed with illustrative photographs. It is suggested that the clinical characteristics be studied for each of these types to serve the purpose of early and prospective diagnosis.

Studies of Primary Liver Carcinoma.

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