Focal Nodular Hyperplasia and Hepatocellular Adenoma around the World Viewed through the Scope of the Immunopathological Classification
oleh: Charles Balabaud, Wesal R. Al-Rabih, Pei-Jer Chen, Kimberley Evason, Linda Ferrell, Juan C. Hernandez-Prera, Shiu-Feng Huang, Thomas Longerich, Young Nyun Park, Alberto Quaglia, Peter Schirmacher, Christine Sempoux, Swan N. Thung, Michael Torbenson, Aileen Wee, Matthew M. Yeh, Shiou-Hwei Yeh, Brigitte Le Bail, Jessica Zucman-Rossi, Paulette Bioulac-Sage
| Format: | Article |
|---|---|
| Diterbitkan: | Wiley 2013-01-01 |
Deskripsi
Focal nodular hyperplasia (FNH) and hepatocellular adenoma (HCA) are benign hepatocellular tumors. The risk of bleeding and malignant transformation of HCA are strong arguments to differentiate HCA from FNH. Despite great progress that has been made in the differential radiological diagnosis of the 2 types of nodules, liver biopsy is sometimes necessary to separate the 2 entities. Identification of HCA subtypes using immunohistochemical techniques, namely, HNF1A-inactivated HCA (35–40%), inflammatory HCA (IHCA), and beta-catenin-mutated inflammatory HCA (b-IHCA) (50–55%), beta-catenin-activated HCA (5–10%), and unclassified HCA (10%) has greatly improved the diagnostic accuracy of benign hepatocellular nodules. If HCA malignant transformation occurs in all HCA subgroups, the risk is by far the highest in the β-catenin-mutated subgroups (b-HCA, b-IHCA). In the coming decade the management of HCA will be more dependent on the identification of HCA subtypes, particularly for smaller nodules (<5 cm) in terms of imaging, follow-up, and resection.