Clinical history: 2 year old boy with liver mass. Elevated AFP and hCG.
What is the most probable diagnosis?
Hepatoblastoma, small cell pattern
On low power you see that the normal liver parenchyma is replaced by fibrosis and islands of blue cells with central pools of necrosis. On higher power you can appreciate that the small round blue cells with minimal cytoplasm and oval hyperchromatic nuclei that resemble small cell carcinoma at other sites.
For exams know:
Hepatoblastoma is the most common primary liver tumor in children
90% before age 5, males are twice as likely as females
It is on your differential list for small round blue cell tumors and is composed of immature hepatocytic elements