'Atypical adenomatous hyperplasia' in liver cirrhosis: low-grade hepatocellular carcinoma or borderline lesion?

Abstract:

:Adenomatous hyperplasia, defined as a sizable parenchymal nodule in cirrhosis, was examined morphologically. Ninety-seven nodules of adenomatous hyperplasia were obtained from 47 cirrhotic livers and were divided into 'ordinary' (44 nodules) and 'atypical' (53 nodules) types. The former consisted of hepatocytes similar to those of the surrounding liver, and showed regularly distributed portal tracts. The latter type was composed of hepatocytes showing nuclear atypia, relative to the surrounding liver, and showed irregular or sparse portal tracts. Atypical nodules were histologically heterogeneous, possessing areas of normo-trabecular, compact, pseudoglandular and/or scirrhous patterns. Several cytological changes, such as clear cell change, small or large cell change and fatty change, were intermingled variably within a given nodule. Atypical nodules showed expansive and/or replacing growth into the surrounding liver. Atypical hepatocytes also infiltrated into the fibrous septa and portal tracts. Foci of overt hepatocellular carcinoma were found in 11 of the 53 atypical nodules. These findings suggest that ordinary adenomatous hyperplasia may be a large-sized regenerative nodule, while atypical adenomatous hyperplasia may be a hepatocellular neoplasm, a peculiar form of low-grade hepatocellular carcinoma or borderline lesion, in which overt hepatocellular carcinoma is likely to evolve through multiple steps.

journal_name

Histopathology

journal_title

Histopathology

authors

Nakanuma Y,Terada T,Terasaki S,Ueda K,Nonomura A,Kawahara E,Matsui O

doi

10.1111/j.1365-2559.1990.tb00660.x

subject

Has Abstract

pub_date

1990-07-01 00:00:00

pages

27-35

issue

1

eissn

0309-0167

issn

1365-2559

journal_volume

17

pub_type

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