Focal Nodular Hyperplasia and Hepatocellular Adenoma around the World Viewed through the Scope of the Immunopathological Classification

Author:

Balabaud Charles1ORCID,Al-Rabih Wesal R.2,Chen Pei-Jer34,Evason Kimberley5,Ferrell Linda5,Hernandez-Prera Juan C.6,Huang Shiu-Feng3,Longerich Thomas7,Park Young Nyun8,Quaglia Alberto2,Schirmacher Peter7,Sempoux Christine9,Thung Swan N.6,Torbenson Michael10,Wee Aileen11,Yeh Matthew M.12,Yeh Shiou-Hwei3,Le Bail Brigitte113,Zucman-Rossi Jessica1415,Bioulac-Sage Paulette113

Affiliation:

1. Inserm U1053, Université Bordeaux Segalen, 33076 Bordeaux Cedex, France

2. Institute of Liver Studies, King’s College Hospital, London, UK

3. National Taiwan University College of Medicine, Taipei, Taiwan

4. National Taiwan University Hospital, Taipei, Taiwan

5. Department of Pathology, University of California, San Francisco, CA 94143-0102, USA

6. Department of Pathology, Mount Sinai School of Medicine, New York, NY 10029, USA

7. Institute of Pathology, University Hospital, 69120 Heidelberg, Germany

8. Department of Pathology, Yonsei University College of Medicine, P.O. Box 8044, Seoul, Republic of Korea

9. Service d'Anatomie Pathologique, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, 1200 Brussels, Belgium

10. Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

11. Department of Pathology, Yong Loo Lin School of Medicine, National University of Singapore, National University Hospital, National University Health System, Singapore 119074

12. Department of Pathology, University of Washington School of Medicine, Seattle, WA, USA

13. Pathology Department, Hôpital Pellegrin, CHU Bordeaux, 33076 Bordeaux Cedex, France

14. Inserm, UMR-674, Génomique Fonctionnelle des Tumeurs Solides, IUH, 75010 Paris, France

15. Université Paris Descartes, Labex Immunooncology, Sorbonne Paris Cité, Faculté de Médecine, 75005 Paris, France

Abstract

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 theβ-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.

Funder

Association pour la Recherche sur le Cancer

Publisher

Hindawi Limited

Subject

Hepatology

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