Hepatic adenoma and focal nodular hyperplasia: Clinical, pathologic, and radiologic features

Kerlin, Paul; Davis, Gary L.; McGill, Douglas B.; Weiland, Louis H.; Adson, Martin A.; Sheedy, Patrick F.

doi:10.1016/0016-5085(83)90202-0

Cited by 257 publications

(151 citation statements)

References 18 publications

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“…28,30,31935 Th e ability of hepatic adenomas, a lesion clearly related to estrogen use, 30,31,34,36,37 to transform to HCC provides yet another link in the chain of evidence incriminating estrogen use in the pathogenesis of HCC. There are, including this report, now eight cases27,34,35,37-39 of hepatic adenomas demonstrating malignant transformation to HCC.…”

Section: Demographic and Etiologic Factorsmentioning

confidence: 99%

Hepatoma in the noncirrhotic liver

Smalley

Moertel

Hilton

et al. 1988

Cancer

111

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The pathologic features, clinical presentation and natural history of hepatocellular carcinoma (HCC) developing in the noncirrhotic liver were studied in 61 patients against a background of 63 patients seen concurrently with HCC complicating cirrhosis. Noncirrhotic HCC had a bimodal age distribution, with females predominating the first age-clustering (10-50 years) and males predominating the second age-clustering (50-90 years). Cirrhotic HCC had a unimodal age distribution (40-90 years) with male dominance throughout. Estrogen exposure was noted in 57% of the noncirrhotic HCC women overall and in 80% of those in the younger age-clustering. The majority of noncirrhotic HCC presented with a single hepatic mass or a dominant primary with satellite lesions in contrast to the usual multinodular or diffuse disease seen with cirrhosis. Twenty-nine noncirrhotic patients survived complete resection of disease limited to the liver and exhibited a median survival of 2.7 years with a 5-year survival of 25%. Low histologic grade, minimal necrosis, and the absence of hemoperitoneum, hepatomegaly, and adjacent organ involvement were all favorable prognostic variable. Patients with metastatic or locally unresectable noncirrhotic HCC had a median survival of 9 months, and 24% survived in excess of 2 years. This survival experience is significantly more favorable than cirrhotic HCC patients, who had only a 1.2-month median and a 3% 2-year survival. Low histologic grade, mild mitotic activity and the presence of some fibrosis within the specimen were associated with a favorable outcome in advanced noncirrhotic HCC. The favorable prognosis and heterogeneous composition of the noncirrhotic, when compared to the cirrhotic HCC cohort, may be important considerations in the design and evaluation of future clinical trials.

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Section: Demographic and Etiologic Factorsmentioning

confidence: 99%

Hepatoma in the noncirrhotic liver

Smalley

Moertel

Hilton

et al. 1988

Cancer

111

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“…ence of a preexisting vascular malformation [1][2][3]. Histologically, FNH consists of a core of fibrous tissue containing the feeding artery, an abnormal arrangement of ultrastructurally normal hepatocytes, Kupffer cells, and proliferating bile ducts lying between radiating hypervascular septae.…”

mentioning

confidence: 98%

Power Doppler imaging and evaluation of the resistive index in focal nodular hyperplasia of the liver

et al. 1997

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Focal lesions of the liver represent a significant diagnostic problem for various imaging modalities. The aim of this study was to assess the value of power Doppler sonography versus conventional color Doppler imaging in the depiction of hypervascular focal nodular hyperplasia (FNH) of the liver and to investigate the resistive index (RI) in the lesions' feeding arteries. Eighteen histologically proved FNHs in 14 patients were evaluated by gray-scale ultrasound, conventional color Doppler, and power Doppler sonography. With conventional color Doppler, a feeding arterial vessel could be depicted in only 4/18 lesions and hypervascularization was detected in 6/18 lesions. Power Doppler was more sensitive in detecting feeding arteries (16/18) within hypervascular lesions (15/18). RI values in the feeding arteries (mean = 0.51) significantly differed from those in the main hepatic artery or its intraparenchymal branches (mean = 0.68) in the same patient. The mean RI-difference was 0.19, suggesting hemodynamically significant arteriovenous shunting. Power Doppler sonography significantly increases sensitivity in the diagnosis of focal nodular hyperplasia of the liver and reliably permits the distinction of these lesions from hepatocellular carcinomas.

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“…Aus diesem Grund und zur Prophylaxe etwaiger intraperitonealer Blutungen, einer weiteren Komplikation des Leberzelladenoms, ist die derzeitige Therapie der Wahl die chirurgische Resektion [5,8,9], obwohl Einzelfäl-le beschrieben wurden, in denen sich im ehemaligen Resektionsgebiet eines Leberzelladenoms ein HCC entwickelte [6].…”

Section: Fallbeschreibungunclassified