Hepatic adenoma: MR findings in 51 pathologically proved lesions.

Arrivé, Lionel; Fléjou, Jean‐François; Vilgrain, Valérie; Belghiti, J; Najmark, D; Zins, Marc; Menu, Y.; Tubiana, Jean-Michel; Nahum, H

doi:10.1148/radiology.193.2.7972769

Cited by 134 publications

(67 citation statements)

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“…These results can be explained by the highly variable radiological behaviors of HA according to the presence of steatosis, necrosis, bleeding, or malignant transformation, as well as by the similarities to some cases of focal nodular hyperplasia and fibrolamellar hepatocarcinoma. MRI appears to be more effective, and identifies HA in 75% of cases [8,12,13,15] . In the present study, the low preoperative diagnostic accuracy is explained by the long study period and the use of radiological examinations with low accuracy for the initial patients.…”

Section: Management Of Solitary-uncomplicated Hamentioning

confidence: 93%

Management of hepatocellular adenoma: Solitary-uncomplicated, multiple and ruptured tumors

Toso

Majno²,

Andrés³

et al. 2005

WJG

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Section: Management Of Solitary-uncomplicated Hamentioning

confidence: 93%

Management of hepatocellular adenoma: Solitary-uncomplicated, multiple and ruptured tumors

Toso

Majno²,

Andrés³

et al. 2005

WJG

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“…This risk can therefore only be estimated from the pathological records of operated patients. In surgical series of more than 20 patients [11,12,14,15,16,17,18,19,20,21,22,23,24,25,26,27], the proportion of HA with malignant transformation is 5% and this figure appears very reproducible over time (table 1). One has to realize that it is only a rough estimate of the risk of malignancy of HA for two reasons:…”

Section: Risk Of Malignant Transformation Of Hamentioning

confidence: 98%

Malignant Transformation of Liver Adenoma: An Analysis of the Literature

Farges

Dokmak²

2010

Dig Surg

102

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As adenoma in other locations, hepatic adenoma (HA) may transform into hepatocellular carcinoma (HCC) and hepatocyte dysplasia is most probably the intermediate step between both conditions. Malignant HA may appear as microscopic or macroscopic areas of HCC within the HA. These areas are typically well differentiated and without vascular extension or satellite nodules. AFP measurements are not reliable as they are usually normal. The risk of malignant transformation of HA cannot be reliably quantified yet. Several series are concordant to show that approximately 5% of patients whose HA have been resected had pathological evidence of HCC within their HA. This figure however does not take into account fully transformed HA where evidence of the preexisting benign lesion might have disappeared. The risk of malignant transformation is correlated with the diameter of the HA and it is very unusual when it is <5 cm and the same holds true for patients with multiple HA. These results suggest that small HA could be safely observed as they are also at low risk of bleeding. These conclusions might not apply to male patients who are at lower risk of HA, except in specific conditions, but appear to be at a much higher risk of malignant changes.

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“…[10][11][12][13][14][15][16][17] MRI is considered the most comprehensive and noninvasive imaging work-up for HCA diagnosis. 11,12,15,16 MRI findings include fatty, necrotic, and hemorrhagic components, but a homogeneous hypervascular appearance may also be observed.…”

mentioning

confidence: 99%

Hepatocellular adenomas: Magnetic resonance imaging features as a function of molecular pathological classification

et al. 2008

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Hepatocellular adenomas (HCAs) are a group of benign tumors forming three molecular pathological subgroups: (1) hepatocyte nuclear factor 1␣ (HNF-1␣)-inactivated, (2) ␤-catenin-activated, and (3) inflammatory. Some HCAs present both ␤-catenin activation and inflammation. We analyzed magnetic resonance imaging (MRI) data for correlations between features on imaging and pathological classification of HCAs. We included 50 cases for which pathology specimens were classified into three groups based on immunohistochemical staining. Two characteristic MRI profiles were identified corresponding to HNF-1␣-inactivated and inflammatory HCAs. Fifteen HCAs were HNF-1␣-inactivated. The corresponding lesions showed (1) diffuse signal dropout on T1-weighted chemical shift sequence due to steatosis, (2) isosignal or slight hypersignal on T2-weighted (T2W) images, and (3) moderate enhancement in the arterial phase, with no persistent enhancement in the portal venous and delayed phases. For the diagnosis of HNF-1␣-inactivated HCA, the positive predictive value of homogeneous signal dropout on chemical shift images was 100%, the negative predictive value was 94.7%, the sensitivity was 86.7%, and the specificity was 100%. Twenty-three HCAs were inflammatory and showed (1) an absence or only focal signal dropout on chemical shift sequence; (2) marked hypersignal on T2W sequences, with a stronger signal in the outer part of the lesions, correlating with sinusoidal dilatation areas; and (3) strong arterial enhancement, with persistent enhancement in the portal venous and delayed phases. Marked hypersignal on T2W sequences associated with delayed persistent enhancement had a positive predictive value of 88.5%, a negative predictive value of 84%, a sensitivity of 85.2%, and a specificity of 87.5% for the diagnosis of inflammatory HCA. Conclusion: HNF-1␣-mutated HCAs and inflammatory HCAs were associated with specific MRI patterns related to diffuse fat repartition and sinusoidal dilatation, respectively. (HEPATOLOGY 2008;48:808-818.) H epatocellular adenoma (HCA) is a rare type of benign monoclonal liver neoplasm, occurring mostly in young women using oral contraceptives. Several molecular features associated with HCA have recently been described (for review, see Rebouissou et al. 1 ).Biallelic-inactivating mutations of the TCF1 gene inactivating hepatocyte nuclear factor 1␣ (HNF-1␣) have been identified in 35% to 50% of HCAs. 2-4 Furthermore, HCAs harboring HNF-1␣ mutations have been shown to display repressed gluconeogenesis, together with activa-

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Hepatic adenoma: MR findings in 51 pathologically proved lesions.

Abstract: Presence of a peripheral rim, heterogeneity, and hyperintensity are common features of hepatic adenoma.

Cited by 134 publications

References 0 publications

Management of hepatocellular adenoma: Solitary-uncomplicated, multiple and ruptured tumors

Management of hepatocellular adenoma: Solitary-uncomplicated, multiple and ruptured tumors

Malignant Transformation of Liver Adenoma: An Analysis of the Literature

Hepatocellular adenomas: Magnetic resonance imaging features as a function of molecular pathological classification

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