Case1 Fig1A 19-year-old female with a 7.8 cm heterogeneously enhancing mass that was found on imaging after patient was in MVC. No personal or family history of liver disease, contraceptive use, hepatitis, or other malignancy. No significant unintentional weight loss or jaundice. MRI of the abdomen showed 7.3 x 6.2 cm lesion with lobular margins and several punctate calcifications within the central aspect of this lesion Figure (1). The patient underwent partial hepatectomy. Macroscopic examination revealed 8 x 6.3 x 6 cm tan-yellow firm ovoid mass. The remaining cut surface of the liver is red-brown and soft.

 What is the most likely diagnosis?

A. Focal Nodular Hyperplasia (FNH)
B. Hepatic adenoma
C. Cirrhosis hepatocellular carcinoma.
D. Fibrolamellar hepatocellular carcinoma (FLC).


Case2 Fig1A 25-year-old African-American woman with a 3-month history of right upper quadrant continuous abdominal pain. Past medical history significant for amenorrhea secondary to Depo-Provera use for approximately 9 years. No other personal or family history of liver disease or cancer. No significant weight loss. Abdominal CT scan showed poorly defined isoattenuating lesion at hepatic dome with irregular central hypoattenuation. Macroscopic examination revealed a 9.2 x 9.0 x 4 .3 cm sub-capsular tan-yellow, well circumscribed, lobulated mass with 2.5 x 1.2 cm central white homogenous area. The remaining hepatic parenchyma was unremarkable.

 What is the most likely diagnosis?

A. Large hepatic adenoma
B. Scirrhous hepatocellular carcinoma
C. Fibrolamellar hepatocellular carcinoma (FLC).
D. Cirrhotomimetic hepatocellular carcinoma (Diffuse HCC / Cirrhotic-like HCC)


Cellblock2c HE2c 400x85 y/o M w/ remote h/o lymphoma treated with nephrectomy, splenectomy and radiation. Now presenting with a new RLL lung mass and cystic lesions in the ribs and scapula. The specimen is a fine needle aspirate of the 7th right rib.

 What is the most likely diagnosis?

A. Diffuse large B-cell lymphoma.
B. Metastatic prostatic adenocarcinoma.
C. Melanoma.
D. Metastatic renal cell carcinoma.


Twitter177 year old woman with left upper lid lesion noted for 4 months with no pain or enlargement. Clinical impression: benign cyst.

 What is the most likely diagnosis?

A. Endocrine mucin producing sweat gland carcinoma.
B. Nodular hidradenoma/hidradenocarcinoma.
C. Nodular basal cell carcinoma.
D. Adenoid cystic carcinoma.


Picture159 yo F w/ insidious onset of jaundice, ascites, & elevated transaminases. Prior liver biopsies revealed portal fibrosis & cholestasis. Patient deemed to have cryptogenic cirrhosis & transplantation performed.

 What is the most likely diagnosis?

A. Portal fibrosis and cirrhosis.
B. Hepatoportal sclerosis.
C. Hepatic amyloidosis.
D. Thorotrast deposition.


Picture1 Case5264 year old man with hematuria undergoes a TURP for urinary obstruction and bulky mass per digital rectal examination. Representative microphotographs of the resected tissue are shown. 

 What is the most likely diagnosis?

A. Prostatic adenocarcinoma.
B. Small cell carcinoma of the prostate.
C. Rhabdomyosarcoma.
D. Urothelial carcinoma.