Hepatocellular adenoma subtypes: the impact of overweight and obesity

Bioulac‐Sage, Paulette; Taouji, Saı̈d; Possenti, Laurent; Balabaud, Charles

doi:10.1111/j.1478-3231.2012.02786.x

Cited by 114 publications

(97 citation statements)

References 19 publications

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“…Importantly, Agarwal et al (11) report that 11 patients with inflammatory HCAs in their study that were iso-or hyperintense on HPB phase MR images mimicked FNH on MR images obtained with conventional sequences. Given the lack of reliable MR features in the diagnosis of inflammatory HCAs, if a patient has risk factors for inflammatory HCA (obesity, metabolic syndrome, alcohol use), a multidisciplinary approach may be required (41,42). A trial of cessation of contraceptive medications and follow-up may be considered; lesions that remain larger than 5 cm after follow-up or that are suspected to be malignant may require surgical resection (39).…”

Section: Discussionmentioning

confidence: 98%

Focal Nodular Hyperplasia and Hepatocellular Adenoma: Accuracy of Gadoxetic Acid–enhanced MR Imaging—A Systematic Review

McInnes¹,

Hibbert²,

Inácio³

et al. 2015

Radiology

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Section: Discussionmentioning

confidence: 98%

Focal Nodular Hyperplasia and Hepatocellular Adenoma: Accuracy of Gadoxetic Acid–enhanced MR Imaging—A Systematic Review

McInnes¹,

Hibbert²,

Inácio³

et al. 2015

Radiology

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“…The last risk factors significantly associated with occurrence of IHCA are alcohol consumption and obesity. 14,15,22,123 The mechanisms linking these 2 metabolic disorders with the occurrence of HCA showing an autonomous IL-6/JAK/ STAT3 activation remain to be investigated, taking into account both environmental factors and genetic backgrounds. 124 The direct toxic role of alcohol or a role of cytokine production observed during long-term alcohol consumption and in obese patients cannot be excluded.…”

Section: Translation In Clinical Carementioning

confidence: 99%

Hepatocellular Benign Tumors—From Molecular Classification to Personalized Clinical Care

2013

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“…The absence of the above markers identifies unclassified HCA (less than 10%). The differential diagnosis between FNH and HCA is important as well as the identification of HCA subtypes thought to be of great importance for the present and future management [19][20][21][22] . Indeed, in the past there has been a great confusion between FNH and HCA [23,24] .…”

Section: Hepatocellular Adenomamentioning

confidence: 99%

Pictures of focal nodular hyperplasia and hepatocellular adenomas

Sempoux¹,

Balabaud²,

Bioulac‐Sage³

2014

WJH

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This practical atlas aims to help liver and non liver pathologists to recognize benign hepatocellular nodules on resected specimen. Macroscopic and microscopic views together with immunohistochemical stains illustrate typical and atypical aspects of focal nodular hyperplasia and of hepatocellular adenoma, including hepatocellular adenomas subtypes with references to clinical and imaging data. Each step is important to make a correct diagnosis. The specimen including the nodule and the non-tumoral liver should be sliced, photographed and all different looking areas adequately sampled for paraffin inclusion. Routine histology includes HE, trichrome and cytokeratin 7. Immunohistochemistry includes glutamine synthase and according to the above results additional markers such as liver fatty acid binding protein, C reactive protein and beta catenin may be realized to differentiate focal nodular hyperplasia from hepatocellular adenoma subtypes. Clues for differential diagnosis and pitfalls are explained and illustrated. Key words: Focal nodular hyperplasia; Hepatocellular adenoma; Inflammatory hepatocellular adenoma; Beta catenin; Hepatocyte nuclear factor 1 alpha Core tip: In this paper are illustrated macroscopic and microscopic aspects of focal nodular hyperplasia and hepatocellular adenoma. These illustrations represent typical as well as less usual aspects of these two benign hepatocellular tumors. Microscopic pictures are performed using classical routine stains such as HE, trichrome or cytokeratin 7 or less usual markers proven of great interest to identify focal nodular hyperplasia (FNH) such as glutamine synthase or liver fatty acid briding protein, C reactive protein or b catenin to identify hepatocyte nuclear factor 1 alpha mutated hepatocellular adenoma (HCA), inflammatory HCA, β-catenin mutated HCA respectively. These illustrations combined with brief clinical information should be helpful for pathologists for their practice. Indeed if FNH are rather frequent tumor easy to recognize, there are difficulties when key features are lacking or when features such as steatosis or sinusoidal dilatation, features of HCA, are present. The great message of this paper is the possibility to identify HCA subtypes, a key feature for the coming years to better manage patients.Sempoux C, Balabaud C, Bioulac-Sage P. Pictures of focal nodular hyperplasia and hepatocellular adenomas.

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Hepatocellular adenoma subtypes: the impact of overweight and obesity

Abstract: We propose that overweight/obesity may soon represent a major risk of malignant transformation of HCA, possibly via the IL-6 pathway.

Cited by 114 publications

References 19 publications

Focal Nodular Hyperplasia and Hepatocellular Adenoma: Accuracy of Gadoxetic Acid–enhanced MR Imaging—A Systematic Review

Focal Nodular Hyperplasia and Hepatocellular Adenoma: Accuracy of Gadoxetic Acid–enhanced MR Imaging—A Systematic Review

Hepatocellular Benign Tumors—From Molecular Classification to Personalized Clinical Care

Pictures of focal nodular hyperplasia and hepatocellular adenomas

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