MACROSCOPIC DESCRIPTION: 1. "Segment 7 liver resection": A liver segmentectomy 110 x 80 x 35 mm and 196 g. There is a resection margin 105  x 80 mm (inked black). Adjacent to the resection margin there is an area where the capsule has been stripped 75 x 45 mm (inked blue). The remaining liver capsule is shiny smooth and unremarkable. There is a well demarcated rubbery tan tumour 31 x 25 x 19 mm. The tumour is 14 mm from the resection margin and 3 mm from the unremarkable liver capsule. The remaining liver is unremarkable. BLOCK DESIGNATION: A - tumour with resection margin. B-C - tumour with liver capsule. D-E - tumour with adjacent normal liver parenchyma. F - normal liver. P6. 2. "4A liver resection": An irregular piece of liver 32 x 17 x 15 mm, 3.8 g. The surface inked all black. Sectioning reveals unremarkable liver. A focal lesion is not identified. 6xTS. A3. (SK)

MICROSCOPIC DESCRIPTION: 1. Sections of the liver show a well demarcated tumour comprising cords of bland hepatocytes 1-2 cells thick, separated by sinusoids. The architecture is haphazard and lacks normal portal tracts. The tumour cells have abundant granular eosinophilic cytoplasm with occasional steatosis, round nuclei, speckled chromatin and conspicuous nucleoli. Mitosis and necrosis are not seen. There is no lymphovascular or perineural invasion. The tumour is 10mm from the resection margin and 5mm from the liver capsule. Liver parenchyma adjacent to and away from tumour shows intact normal lobular architecture. There is a mild, patchy portal infiltrate of lymphocytes and occasional eosinophils. A mild sinusoidal infiltrate of neutrophils is present, which occasionally is more prominent at central venules. There is no evidence of cirrhosis. Reticulin stains to follow. 2. Sections show liver parenchyma with intact normal lobular architecture. There is a mild portal infiltrate of lymphocytes, plasma cells and occasional eosinophils, however there is no expansion of portal tracts or infiltration of biliary epithelium. The lobules show a mild patchy sinusoidal infiltrate of neutrophils. A focal lesion is not identified.

DIAGNOSIS: 1. Segment 7 liver: Hepatocellular adenoma, completely excised. 2. Segment 4A liver: Liver parenchyma with mild non-specific portal infiltrate. No focal lesion identified. SUPPLEMENTARY REPORT Further levels on specimen 2 show a benign haemangioma. Final diagnosis 2. Segment 4A : Benign haemangioma.

SUPPLEMENTARY REPORT: (18/9/14) The tumour cells are CRP positive. There is no loss of staining with L-FABP. Glutamine synthetase is negative. This immunoprofile is in keeping with inflammatory hepatocellular adenoma.

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