The steatohepatitic variant of hepatocellular carcinoma and its association with underlying steatohepatitis

Salomao, Marcela A.; Remotti, Helen; Vaughan, Roger; Siegel, Abby B.; Lefkowitch, Jay H.; Moreira, Roger K.

doi:10.1016/j.humpath.2011.07.005

Cited by 158 publications

(211 citation statements)

References 39 publications

(44 reference statements)

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“…Since intralesional fat is characteristic of early but-with the exception of the steatohepatitic variant of HCC (121)not progressed HCC (41), HCCs with this feature may have more favorable prognosis, with longer time to progression and less risk of developing metastases, than non-fat-containing HCCs (122). Steatohepatitic HCC is a newly described variant of HCC with histologic features that resemble those of steatohepatitis in nonneoplastic liver (eg, steatosis, inflammation, evidence of hepatocyte injury, and pericellular fibrosis) (123). Emerging data suggest this variant occurs most commonly in persons with underlying steatohepatitis.…”

Section: Ancillary Features That Favor the Diagnosis Of Hccmentioning

confidence: 99%

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CT and MR Imaging Diagnosis and Staging of Hepatocellular Carcinoma: Part II. Extracellular Agents, Hepatobiliary Agents, and Ancillary Imaging Features

Choi¹,

Lee²,

Sirlin³

2014

Radiology

453

385

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Computed tomography (CT) and magnetic resonance (MR) imaging play critical roles in the diagnosis and staging of hepatocellular carcinoma (HCC). The second article of this two-part review discusses basic concepts of diagnosis and staging, reviews the diagnostic performance of CT and MR imaging with extracellular contrast agents and of MR imaging with hepatobiliary contrast agents, and examines in depth the major and ancillary imaging features used in the diagnosis and characterization of HCC.q RSNA, 2014

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Section: Ancillary Features That Favor the Diagnosis Of Hccmentioning

confidence: 99%

“…Emerging data suggest this variant occurs most commonly in persons with underlying steatohepatitis. Although confirmatory studies are needed, it appears that steatohepatitic HCCs may have pronounced intralesional fat even if they are progressed cancers with advanced tumor grade (123).…”

Section: Ancillary Features That Favor the Diagnosis Of Hccmentioning

confidence: 99%

CT and MR Imaging Diagnosis and Staging of Hepatocellular Carcinoma: Part II. Extracellular Agents, Hepatobiliary Agents, and Ancillary Imaging Features

Choi¹,

Lee²,

Sirlin³

2014

Radiology

453

385

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“…They raised the question of altered biologic/morphologic characteristics of HCC in presence of risk factors for NAFLD and NASH. Recently, the same group of authors 10 has identified SH-HCC in 13.5% of HCCs with various etiologies in a span of 3.5 years. Steatohepatitic HCC is characterized by a constellation of SH features such as fatty change, ballooning degeneration, neutrophilic inflammation, perisinusoidal fibrosis, and Mallory bodies.…”

Section: Prevalence Of Steatosis and Nash In The Adjacentmentioning

confidence: 99%

“…7,8 Recently a new morphologic variant of HCC named steatohepatitic hepatocellular carcinoma has been identified that relates to the presence of metabolic syndrome. 9,10 The aim of the study is to recognize steatohepatitic (SH) pattern in HCC cases of various etiologies in Indian patients and to further correlate this variant with the presence of metabolic risk factors.…”

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confidence: 99%

Steatohepatitic Hepatocellular Carcinoma, a Morphologic Indicator of Associated Metabolic Risk Factors: A Study From India

Jain

Nayak

Kumaran

et al. 2013

Archives of Pathology &Amp; Laboratory Medicine

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Context.-The common risk factors for hepatocellular carcinoma (HCC) include persistent viral infection with either hepatitis B or C virus, alcohol abuse, hemochromatosis, and metabolic syndrome. Steatohepatitic (SH) HCC has been recently recognized as a special morphologic variant of HCC associated with metabolic risk factors.Objective.-To assess the SH pattern in HCC cases of various etiologies in Indian patients and to further correlate this morphology with the presence of metabolic risk factors.Design.-A total of 101 cases of HCC with various etiologies in explanted livers from adults were included in the study. Morphologic examination was performed to identify SH lesions within the tumor and in the nontumorous liver parenchyma. Correlation of nontumor and tumor SH morphology with clinically identifiable metabolic risk factors and with non-SH type of HCC was performed.Results.-The SH variant of HCC was identified in 19 livers (18.8%). Most SH-HCC cases were associated with metabolic risk factors such as obesity, diabetes, hypertension, and hyperlipidemias. Comparison of SH-HCC with non-SH-HCC was statistically significant in terms of presence of metabolic risk factors.Conclusions.-Steatohepatitic morphology in HCC is frequent in nonalcoholic fatty liver disease-associated cirrhosis (P ¼ .009) and is significantly associated with metabolic risk factors (P ¼ .03). By recognizing SH pattern, one may predict associated metabolic diseases and determine the prognosis both in pretransplant and posttransplant patients. (Arch Pathol Lab Med. 2013;137:961-966; doi: 10.5858/ arpa.2012-0048-OA) H epatocellular carcinoma (HCC) accounts for 85% to 90% of all primary liver cancers.1 There is wide geographic variation of prevalence of HCC, with Asia and Africa having 40 times more cases than other parts of the world.2 However, the incidence of HCC has been rising throughout the world, with particularly large increases seen in industrialized nations such as the United States and Denmark.3 Nonalcoholic fatty liver disease (NAFLD) ranges in severity from steatosis to steatohepatitis (NASH, nonalcoholic steatohepatitis) and finally to cirrhosis, which is known to be a risk factor for the development of HCC. 4 In Western and Asian countries, the prevalence of NAFLD in the general population is increasing dramatically.5 Genetic factors may in part contribute to the rise in NAFLD. Polymorphisms within various genes have been linked to NAFLD in lean Indian men.6 Emerging evidence has established multiple independent risk factors for the development of HCC in NAFLD, which include obesity, diabetes, and iron deposition. 7,8 Recently a new morphologic variant of HCC named steatohepatitic hepatocellular carcinoma has been identified that relates to the presence of metabolic syndrome.9,10 The aim of the study is to recognize steatohepatitic (SH) pattern in HCC cases of various etiologies in Indian patients and to further correlate this variant with the presence of metabolic risk factors. MATERIALS AND METHODSBetween January 2004 and ...

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“…In the subsequent years in 2012 Salomao et al again reported another series of HCC in which SH-HCC constituted 16/118 of explants HCC's [5]. They also proposed a histological criteria for diagnosis of SH-HCC.…”

Section: Discussionmentioning

confidence: 99%

Steatohepatitic Hepatocellular Carcinoma—A Case Report with Literature Review

Gupta

Rastogi

Bihari

2014

Indian J Surg Oncol

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The steatohepatitic variant of hepatocellular carcinoma and its association with underlying steatohepatitis

Cited by 158 publications

References 39 publications

CT and MR Imaging Diagnosis and Staging of Hepatocellular Carcinoma: Part II. Extracellular Agents, Hepatobiliary Agents, and Ancillary Imaging Features

CT and MR Imaging Diagnosis and Staging of Hepatocellular Carcinoma: Part II. Extracellular Agents, Hepatobiliary Agents, and Ancillary Imaging Features

Steatohepatitic Hepatocellular Carcinoma, a Morphologic Indicator of Associated Metabolic Risk Factors: A Study From India

Steatohepatitic Hepatocellular Carcinoma—A Case Report with Literature Review

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