ONCOCYTIC HEPATOCELLULAR-CARCINOMA WITH NUMEROUS GLOBULAR HYALINE BODIES

Two well circumscribed tumors, oncocytic and non-oncocytic, were remov ed from the non-cirrhotic liver of a 67 year old male, The large oncoc ytic tumor (OCT), occupying the entire left lobe, was multilobulated w ith focal coagulation necrosis and areas of hemorrhage. Light microsco py revealed that it consisted of exclusively large, granular oxyphilic cells with moderate nuclear atypia and occasional mitotic figures, wh ich were trabecular and/or pseudoglandular in structure, but no lamell ar fibrosis was seen. Characteristically, the OCT cells included numer ous globular hyaline bodies (GHB) of various sizes which were stained red with acid fuchsin and deep blue or magenta with phosphotungstic ac id hematoxylin (PTAH), but negative for periodic acid Schiff (PAS), or cein, rhodamine and Grimelius methods. Immunohistochemically, alpha-fe toprotein (AFP), alpha-1-antitrypsin, alpha-1-antichymotrypsin, fibrin ogen and ferritin were all negative. On ultrastructural examination, t umor cells were mitochondria rich, including electron dense, ovoid or polyhedral inclusions, with the delineated membrane identical with tha t of the GHB. In contrast, the small tumor in the right lobe (Segment 7) was a solid adenoma with no oncocytic transition, Based on these fi ndings, it was postulated that OCT consists of heterogenous proliferat ion of mitochondria-rich hepatocytes which tend to induce lysosomal GH B closely associated with mitochondrial abnormalities.