Focal nodular hyperplasia of the liver: a clinicopathologic study and review of the literature.

Abstract:

:We received the clinical records and pathologic material of 20 patients with biopsy proven hepatic focal nodular hyperplasia. The majority of the patients were females of child bearing age, five of whom had a history of oral use of contraceptives. In every instance focal nodular hyperplasia was an incidental finding; liver function tests were always normal. Focal nodular hyperplasia is a distinct histopathologic entity, distinguishable from liver cell adenoma. Specifically it consists of nodular aggregates of cytologically normal hepatocytes with foci of intranodular bile duct proliferation. Focal nodular hyperplasia appears to be a benign entity, even in patients in whom the lesion was not excised. The association between focal nodular hyperplasia and oral use of contraceptives may be coincidental, although hormonally related vascular changes may be responsible for rupture of the lesion. :The clinical records and biopsy proven material from 20 cases of focal nodular hyperplasia were reviewed, and the English literature on the subject was surveyed. Most of the 20 patients were women of childbearing age. A history of oral contraceptive use was obtained in 5 cases. 3 of the patients were males. The condition was an incidental finding in all 20 cases. Liver function tests were normal. The histopathologic findings are distinguishable from liver cell adenoma. Nodular aggregations of normal hepatocytes with foci of intranodular bile duct proliferation were seen. The nodules blended into the surrounding liver parenchyma while liver cell adenomas are encapsulated masses without the central scar or radiating fibrous septa. Figures illustrate histologic findings of focal nodular hyperplasia. A review of the English literature revealed only 82 acceptable cases of focal nodular hyperplasia, 12 of which were necropsy findings or lacked clinical data. A few cases have been among males. The association with use of oral contraceptives may be only coincidental. Only 29 of the 82 were 18 years of age or older, 2 of whom were women. Mean age of adult males was 42 years and of adult females, 34 years. In 16 patients the focal nodular hyperplasia had been an incidental finding but in 13 there had been either an abdominal mass or symptoms of abdominal discomfort, nausea, and vomiting. Focal nodular hyperplasia is a benign lession. Removal is unnecessary except in large tumors. It is possible that hormonally related vascular changes may lead to rupture of the lesion with intraabdominal hemorrhage.

journal_name

Hum Pathol

journal_title

Human pathology

authors

Knowles DM,Wolff M

doi

10.1016/s0046-8177(76)80101-3

subject

Has Abstract

pub_date

1976-09-01 00:00:00

pages

533-45

issue

5

eissn

0046-8177

issn

1532-8392

pii

S0046-8177(76)80101-3

journal_volume

7

pub_type

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