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Miller GC, Campbell CM, Manoharan B, Bryant R, Cavallucci D, O'Rourke N, Clouston AD. Subclassification of hepatocellular adenomas: practical considerations in the implementation of the Bordeaux criteria. Pathology 2018; 50:593-599. [PMID: 30149989 DOI: 10.1016/j.pathol.2018.05.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 05/04/2018] [Accepted: 05/11/2018] [Indexed: 12/30/2022]
Abstract
Hepatocellular adenomas are benign liver lesions with a risk of rupture and malignant transformation. Various molecular subgroups have been identified which appear to have characteristic morphological and immunohistochemical features. We examined the morphology and immunohistochemical profile of a series of 121 HCA from 97 patients to identify the HCA subtypes present and determine the number at risk for malignant transformation according to the World Health Organization (WHO) criteria for hepatocellular adenomas. There were 34 HNF1α inactivated HCA (28%), 61 inflammatory HCA (50%), 15 β-catenin activated HCA (12%) and 11 unclassified adenomas (9%). This proportion of cases was similar to that seen in other series utilising molecular classification. The morphological features of the adenomas were suggestive but not definite indicators of the subtypes present. Morphological features that showed overlap between the subtypes included steatosis within the lesion, a ductular reaction and focal atypia, so that immunohistochemical typing was required for accurate classification. In conclusion, immunohistochemistry is a clinically useful surrogate for identifying underlying molecular changes in the HCA subtypes.
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Affiliation(s)
- Gregory C Miller
- Envoi Specialist Pathologists, Brisbane, Qld, Australia; Faculty of Medicine, University of Queensland, Brisbane, Qld, Australia.
| | | | | | - Richard Bryant
- Faculty of Medicine, University of Queensland, Brisbane, Qld, Australia; Department of Surgery, Royal Brisbane and Women's Hospital, Brisbane, Qld, Australia
| | - David Cavallucci
- Faculty of Medicine, University of Queensland, Brisbane, Qld, Australia; Department of Surgery, Royal Brisbane and Women's Hospital, Brisbane, Qld, Australia
| | - Nicholas O'Rourke
- Faculty of Medicine, University of Queensland, Brisbane, Qld, Australia; Department of Surgery, Royal Brisbane and Women's Hospital, Brisbane, Qld, Australia
| | - Andrew D Clouston
- Envoi Specialist Pathologists, Brisbane, Qld, Australia; Faculty of Medicine, University of Queensland, Brisbane, Qld, Australia
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Goltz D, Fischer HP. [Hepatocellular tumours in noncirrhotic liver tissue]. DER PATHOLOGE 2015; 36:597-606; quiz 607-8. [PMID: 26496997 DOI: 10.1007/s00292-015-0113-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In recent years, the spectrum of tissue-based diagnostics of hepatocellular tumours has changed due to novel molecular pathological findings. Innovative radiographics filter out small lesions and ambiguous tumours for bioptical sampling. The spectrum of these tumours includes hepatocellular carcinoma, hepatocellular adenomas, focal nodular hyperplasia and macroregenerative nodules. Primarily, morphological analysis should identify the dignity of a lesion. After exclusion of HCC and reactive liver cell nodules, hepatocellular adenomas should be further subclassified based on immunohistochemical/molecular pathological criteria according to the WHO classification of liver tumours. This procedure provides significant additional information regarding the prognosis and therapeutic implications of hepatocellular adenomas.
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Current Proceedings in the Molecular Dissection of Hepatocellular Adenomas: Review and Hands-on Guide for Diagnosis. Int J Mol Sci 2015; 16:20994-1007. [PMID: 26404250 PMCID: PMC4613237 DOI: 10.3390/ijms160920994] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Revised: 08/10/2015] [Accepted: 08/19/2015] [Indexed: 02/07/2023] Open
Abstract
Molecular dissection of hepatocellular adenomas has brought forward a diversity of well-defined entities. Their distinction is important for routine practice, since prognosis is tightly related to the individual subgroup. Very recent activity has generated new details on the molecular background of hepatocellular adenoma, which this article aims to integrate into the current concepts of taxonomy.
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