Which statement about fibrolamellar hepatocellular carcinoma is correct?
- A It arises almost exclusively in cirrhotic livers of elderly men
- B It is defined histologically by a central stellate scar with radiating bands
- C Alpha-fetoprotein is typically normal and the prognosis is better than conventional HCC ✓
- D It metastasizes early to lung and carries a poor prognosis
Correct answer: C. Alpha-fetoprotein is typically normal and the prognosis is better than conventional HCC
Explanation
Fibrolamellar HCC occurs in adolescents and young adults without underlying cirrhosis or viral hepatitis, serum alpha-fetoprotein is characteristically normal, and long-term survival after resection is considerably better than for conventional HCC. A central stellate scar is the imaging hallmark of focal nodular hyperplasia, the main mimic, whereas fibrolamellar HCC shows a central fibrous zone only inconsistently. Its slow growth and resectability explain the favorable outlook, contradicting option D.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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