Hepatocellular Carcinoma Sub-types in North-Central Nigeria: A Histological Review of Liver Biopsies

Abstract

Introduction: Hepatocellular carcinoma (HCC) is the 6th most common cancer worldwide and a greater burden of this disease is born by the hepatitis B virus (HBV) endemic and resource deficient sub-Sahara Africa. This investigation was carried out to determine the pattern of hepatocellular carcinoma sub-types in north-central Nigeria. Materials and Methods: Archival formalin fixed and paraffin embedded 374 liver biopsy specimen blocks were obtained, sectioned, re-stained and examined histologically. Classification of primary liver cancers was done according to standard World Health Organisation criteria.  Results: Chronic HBV infection was found in 219 (58.6%) and cirrhosis in 29 (7.8%) cases. HCC occurred in 76 (20.3%) cases with background cirrhosis in 18 (23.7%) of the HCC. The HCC subtypes found were the trabecular 54 (71.1%), acinar 10 (13.2%) and mixed trabecular and acinar 6 (7.9%), clear cell 5 (6.6%) and fibrolamellar 1 (1.3%) respectively. Conclusion: HCC is the most common histologically diagnosed primary liver cell carcinoma with the trabecular subtype as the predominant variant in Nigeria, followed by the pseudoglandular and the mixed types.