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Liver Cells 1

Liver cells
pathology

Question

Vignette:

A 45-year-old woman comes to the clinic complaining of persistent fatigue, weakness, and a decreased appetite. She also reports a recent weight loss of 15 pounds over the past three months without dieting or exercising. The patient has a 20-year history of heavy alcohol use. On physical examination, the patient's skin and sclerae are icteric. Abdominal examination reveals hepatomegaly. Laboratory tests show increased serum bilirubin, increased aspartate aminotransferase, and increased alanine aminotransferase. An ultrasound of the liver shows a hyperechoic mass in the right lobe. A biopsy of the liver mass is performed, and histologic examination shows malignant cells with abundant eosinophilic cytoplasm and central nuclei, growing in a trabecular pattern.

Question:

The liver tumor in this patient most likely originated from which of the following cell types?

Choices

A) Hepatocytes

B) Kupffer cells

C) Biliary epithelial cells

D) Sinusoidal endothelial cells

E) Stellate cells

Answer

A) Hepatocytes

Explanation

The patient's heavy alcohol use, clinical findings, and histologic appearance of the liver mass are consistent with hepatocellular carcinoma (HCC), a common primary liver cancer that originates from hepatocytes. HCC is often associated with cirrhosis, commonly due to alcohol abuse, hepatitis B or C infection, or non-alcoholic steatohepatitis. Histologically, HCC is characterized by malignant cells with abundant eosinophilic (acidophilic) cytoplasm and central nuclei, growing in a trabecular pattern, similar to normal hepatocytes. Kupffer cells (choice B) are liver macrophages and can give rise to hepatic angiosarcoma but not HCC. Biliary epithelial cells (choice C) can give rise to cholangiocarcinoma. Sinusoidal endothelial cells (choice D) can give rise to hepatic angiosarcoma. Stellate cells (choice E) can give rise to cirrhosis and fibrosis but not HCC.

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