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April 11, 1977

Standard Nomenclature for Primary Hepatic Tumors-Reply

Author Affiliations

Lexington, Ky

JAMA. 1977;237(15):1560-1561. doi:10.1001/jama.1977.03270420027010

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These two letters illustrate anew the ways mens' prejudices obscure their comprehension of the written word. I did not impugn the classification of hepatic tumors propagated by Edmonson. I simply observed that multiple synonyms have made it difficult for nonpathologists to follow recent new developments in medicine. A careful reading of my COMMENTARY discloses my utmost recognition of the nomenclature established by Edmonson in the Atlas of Tumor Pathology. This nomenclature (despite profuse synonyms) has served us well in classifying sundry hepatic growths developing in livers damaged by viruses, toxins, chemicals and alcohol; likewise, it has effectively differentiated the various congenital nodules occurring in livers of the very young.

But new and perplexing things are happening! In men and women in the prime of life with completely normal livers, hepatic growths are developing, some of which are aggressive hepatocellular cancers. The nomenclature used to describe such hepatic tumors