Unique morphologic and clinical features of liver predominant/primary small cell carcinoma - Autopsy and biopsy case series

Amy A. Lo, Edward C. Lo, Haonan Li, Wanying Zhang, Jie Liao, M. Sambasivia Rao, Frank Miller, Guang Yu Yang*

*Corresponding author for this work

Research output: Contribution to journalArticle

8 Scopus citations


Liver predominant small cell carcinoma is rare but often presents as hyperacute liver failure with unknown primary and is a medical emergency. We present 2 autopsy and 7 biopsy cases of liver predominant small cell carcinoma and demonstrate that these patients present with liver failure and identifiable hepatomegaly but lack discrete lesions on imaging as well as no mass lesions identified in other organs including lung. Compared with the multiple nodules of metastatic small cell carcinoma in the liver, unique morphologic feature of liver predominant/primary small cell carcinoma in autopsy and biopsy specimens was a diffuse infiltration of small blue neoplastic cells predominantly in the sinusoidal space in the liver parenchyma. Before diagnosing liver predominant/primary small cell carcinoma, other infiltrating small blue cell neoplasms including lymphoma and peripheral neuroectodermal tumor need to be ruled out through immunohistochemistry. We, therefore, demonstrate that liver biopsy together with a rapid panel of immunostains is necessary to firmly establish a diagnosis of liver predominant small cell carcinoma and allow clinicians to immediately implement potentially lifesaving chemotherapy.

Original languageEnglish (US)
Pages (from-to)151-156
Number of pages6
JournalAnnals of Diagnostic Pathology
Issue number3
Publication statusPublished - Jun 2014



  • Acute liver failure
  • Hyperacute liver failure
  • Small cell carcinoma
  • hepatomegaly

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this