PRKACA and fibrolamellar hepatocellular carcinoma: A subsequent study found the fusion transcript in only ~80% of fibrolamellar carcinomas, but most of the cases in this study did not undergo central pathology review.8 Recently, a clinical test for fibrolamellar carcinoma has been developed based on fluorescent in situ hybridization (FISH) to detect the PRKACA rearrangement and was positive in all of 26 cases of fibrolamellar carcinoma and in none of the conventional hepatocellular carcinomas.9