Macroscopically, HCC may appear as a large solitary tumour or as a multicentric tumour with satellite lesions evident around a central tumour. True multifocal tumours can also occur. The tumours may appear as yellowish-white nodules and may be punctuated with areas of haemorrhage or necrosis.

Microscopically differentiated tumours contain large cells identifiable as being hepatocytic in origin, with clear cytoplasm, and often have a similar appearance to renal cell carcinoma. Undifferentiated or anaplastic tumours have a variable appearance with multiple mitoses and differing cell shape and size depending on type.

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