Encapsulated hepatocellular carcinoma is said to be much more frequent in Japan compared with United States and South Africa.
There are several articles about capsule formation in hepatocellula carcinoma (HCC), but its mechanism has not yet been understood. In this study, 132 autopsy livers and 7 resected livers bearing HCC, obtained at Pathology Department, Kurume University School of Medicine from 1971 to 1977, were examined.
1) Capsule formation was seen in 81 of the 139 cases (58.3%).
2) There was no difference in the frequency of capsule formation between cases with and without liver cirrhosis.
3) In advanced cirrhosis with minute HCC, capsule formation was more frequent (84.6%).
4) Capsule results from collapse and collagenization of reticulin fibers following disappearance of liver cells due to compression by expansive growth of tumor.
5) In all of the cases with capsule formation, intranodular septal formation was seen. There are two possible mechanisms for intranodular septal formation. Most of septa are a result of capsule formation that follows expansive growth of tumor over the capsle. Another explanation is the formation of septa by the collision of tumors of differing histologic pattern.
6) Among the 17 cases showing type II according to Nakashima's classification, two or three histologically different patterns were seen in the one nodule in 8 cases.
7) Many arterics and portal veins are seen around the tumor capsule and some portal veins are flattend. Tumor receives blood supply via arteries and arterial branches around the capsule.
8) The angioarchtectular makeup was different in each area separated by intranodular septa, their histologic patterns was also different.
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