Diagnosis of focal nodular hyperplasia of the liver by needle biopsy

Makhlouf, Hala R.; Abdul-Al, Hala; Goodman, Zachary

doi:10.1016/j.humpath.2005.08.014

Cited by 74 publications

(33 citation statements)

References 15 publications

(20 reference statements)

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“…Bile ductules are usually found at the interface between hepatocytes and fibrous regions (10,11). Increased arterial flow is thought to hyperperfuse the local parenchyma, leading to secondary hepatocellular hyperplasia.…”

Section: -Clinical and Pathological Characteristics Of Fnhmentioning

confidence: 99%

Molecular pathogenesis of focal nodular hyperplasia and hepatocellular adenoma

Rebouissou¹,

Bioulac‐Sage²,

Zucman‐Rossi³

2008

Journal of Hepatology

223

142

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Section: -Clinical and Pathological Characteristics Of Fnhmentioning

confidence: 99%

Molecular pathogenesis of focal nodular hyperplasia and hepatocellular adenoma

Rebouissou¹,

Bioulac‐Sage²,

Zucman‐Rossi³

2008

Journal of Hepatology

223

142

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“…28 The characteristics of these lesions are compared in Table 2. [29][30][31][32] This table does not review cystic, malignant, or infectious etiologies of hepatic nodules. It is important to note that more than one type of nodular lesion can coexist in the same liver; for example, NRH and hepatic adenoma may both be present in the same patient.…”

Section: Differential Diagnosismentioning

confidence: 99%

Nodular regenerative hyperplasia: Not all nodules are created equal

2006

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DefinitionNodular regenerative hyperplasia (NRH) of the liver is an uncommon condition characterized by the diffuse transformation of normal hepatic parenchyma into small, regenerative nodules with little to no fibrosis. A classification system proposed by Wanless in 1990 1 provided histological criteria for the diagnosis of NRH. These included the presence of hepatocellular nodules less than 3 mm in diameter that were not surrounded by fibrosis (nodules graded 0-3ϩ based on the extent of nodularity noted through all fields of the biopsy), and the presence of fibrous septa (graded 0-3). Biopsy specimens that met the criteria of 3ϩ nodularity and 0-1 fibrous septa were classified as nodular regenerative hyperplasia. NRH has been reported to occur in association with other systemic diseases, including rheumatologic disorders, vascular disorders, and myeloproliferative disorders, as well as certain drugs. 1-10 Nodular regenerative hyperplasia may have a prolonged asymptomatic course unless it is complicated by portal hypertension and its sequelae, including variceal bleeding, ascites, and splenomegaly. In this article, the epidemiology, histology, differential diagnosis, and theories of etiology of NRH are reviewed. The diagnosis and treatment of nodular regenerative hyperplasia are also presented.

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“…The large discrepancy we observed in diagnosing FNH might be lowered by performing routine preoperative biopsies. Its utility should be weighed against the risks of sampling errors, bleeding or misinterpretation (i.e., hyperplastic liver tissue interpreted as adenoma by imaging modalities) [17,22,[26][27][28][29]. As expertise and experience in laparoscopic surgery increase, it is likely that laparoscopic resection will be considered more frequently when diagnostic uncertainty exists [30].…”

Section: Discussionmentioning

confidence: 99%