Primary carcinoma of the liver. A histological study of 27 cases of primary carcinoma of the liver from Malawi.

Liver biopsies from 27 Bantu patients with primary carcinoma of the liver from Malawi were examined histologically. All the biopsies showed hepatocellular carcinoma (HCC). Structurally the tumours consisted of trabeculae or groups of such, separated by a variable amount of connective tissue which in a few cases was so pronounced that the tumour had a scirrhous character. Evaluation of the grade of differentiation showed 3 cases to be of grade I, 10 of grade II, 5 of grade III, and 8 of grade IV. The grade could bary in tumour tissue from the same patient, but never extremely so. The histological structure did not differ significantly from that found in other African and Caucasian series. The reticulin structure of tumour tissue was found distinctly different from that of benign tissue and thus an important tool in the differential diagnosis between HCC grade I and normal or cirrhotic liver tissue. Out of 15 patients 12 had cirrhosis which was of the postnecrotic type.