“…Tumor biopsy is not required, because test results can be misleading and are falsely negative in at least 10% of cases, moreover, a tumor dissemination by biopsy is discussed. Preoperative diagnostic imaging still fails to reliably predict the most important prognostic factor, vascular infiltration [22]. Grade I trabecular, only minor cellular atypical signs, bile production, difficult to differentiate from normal parenchyma or adenoma Grade II tubular, pseudoglandular or acinous, modest cellular atypical signs, often bile production Grade III in majority solid with loss of organized structure, modest to high cellular atypical signs, rarely bile production, often vascular infiltration Grade VI solid with complete loss of organized structure, highly dysplastic cellular signs, mismatch of nuclear/plasma relation, very rarely bile production, HCC are heterogeneous tumors with different grades of differentiation in one tumor.…”