New Names for Old Tumors

Mary Wong, Kevin M. Waters, Maha Guindi, Brent K. Larson

Research output: Contribution to journalArticlepeer-review


Objectives: Previous studies described "clear cell"hepatocellular carcinoma (HCC), although definitions have varied. New clear cell subtypes of HCC have been proposed, including chromophobe (C-HCC), steatohepatitic (SH-HCC), and steatotic (S-HCC), and this study assessed the utility and clinical-pathologic profile of these subtypes. Methods: Current histologic definitions, including 3 separate proposed definitions for SH-HCC, were applied to tumors previously characterized as clear cell HCC. Histologic and clinical variables were analyzed. Results: Of 66 HCCs, 51 (77%) were classified using modern definitions, including 34 SH-HCCs, 15 S-HCCs, and 2 C-HCCs. Compared with the most permissive SH-HCC definition, the other 2 definitions designated 30 and 25 SH-HCCs (-12% and-26% cases, respectively). Unsurprisingly, S-HCC and SH-HCC were associated with steatotic clear cells (P <. 0001). S-HCC was also more typically early type and low grade (P =. 0017). The remaining unclassified clear cell HCCs were associated with flocculent (rather than steatotic or optically clear) cytoplasm (P <. 0001) but otherwise demonstrated no discrete clinical-pathologic profile. Conclusions: Current definitions could be used to reclassify the majority of "clear cell"HCCs. The subtypes are significantly correlated with a few variables, suggesting valid differences of the subtypes, although additional study is warranted, particularly to standardize the definition of SH-HCC.

Original languageEnglish (US)
Pages (from-to)698-710
Number of pages13
JournalAmerican journal of clinical pathology
Issue number5
StatePublished - May 1 2021


  • Hepatocellular carcinoma
  • atty liver disease
  • iver
  • lear cell
  • teatohepatitis
  • teatosis

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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