Hepatocellular adenoma and focal nodular hyperplasia: a series of 24 patients with clinicopathological and radiological correlation

Citation
Y. Ji et al., Hepatocellular adenoma and focal nodular hyperplasia: a series of 24 patients with clinicopathological and radiological correlation, CHIN MED J, 113(9), 2000, pp. 852-857
Citations number
20
Language
INGLESE
art.tipo
Article
Categorie Soggetti
General & Internal Medicine
Journal title
CHINESE MEDICAL JOURNAL
ISSN journal
0366-6999 → ACNP
Volume
113
Issue
9
Year of publication
2000
Pages
852 - 857
Database
ISI
SICI code
0366-6999(200009)113:9<852:HAAFNH>2.0.ZU;2-Z
Abstract
Objective To investigate two rare benign lesions, hepatocellular adenoma (H CA) and focal nodular hyperplasia and evaluate differential diagnosis. Methods Twenty-four consecutive patients with presumed HCA and FNH were stu died at the Liver Cancer Institute from January 1996 to May 1999. Preoperat ive assessment included clinical evaluation, symptoms and laboratory tests. New imaging techniques were prospectively appraised in addition to usual t echniques. All had hepatic resections and follow-up. Histologic examination of surgical specimens was obtained in all cases. Results In every instance, MH was an incidental finding. MH consists of nod ular aggregates of cytologically normal hepatocytes with foci of intranodul ar bile duct proliferation. In this series, patients with HCA had larger tu mors and more often were symptomatic but the occurrence was unrelated to or al contraceptive steroids (OCS) usage. Intralesional hemorrhage or necrosis is common, and was seen in 75% of cases. The best imaging procedure in the diagnosis of FNH was MRI. Color Doppler US was a useful adjunct, but CT la cked specificity, making histological diagnosis mandatory. All patients und erwent tumor resected were tumor-free during the follow-up. Conclusions FNH is a distinct histopathologic entity, and is distinguishabl e from HCA. FNH is a hyperplastic response by the liver parenchyma to a pre -existing arterial malformation. HCA is a liver neoplasia and has the poten tial of malignant transformation to HCC. Based on these findings, we believ e that if the clinical suspicion of HCA or FNH is strong, resection is usua lly the best approach if technically feasible and histologic diagnosis is m andatory.