Chronic Hepatitis C with Mild Activity and Cirrhosis

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(Grade 2, Stage 4), Explant specimen.
This 61 year old woman had a long history of transfusion-related chronic hepatitis C and went into clinical liver failure approximately 10 months prior to liver transplantation at this medical center. The explant liver appeared grossly cirrhotic and contained two hepatocellular carcinomas (one of which is seen on this slide, along with the cirrhosis).

Questions

  1. What histologic marker(s) of hepatitis C virus infection is/are present?
  2. What is the typical form of single-cell death of hepatocytes in chronic hepatitis C?
  3. Can you locate theHCCin the slide? What features distinguish this carcinoma from the underlying cirrhosis?
  4. What diagnostic methods would have been used for surveillance forHCCin this patient?

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