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Clinicopathological features of focal nodular hyperplasia-like nodules in 130 cirrhotic explant livers

(2006) AMERICAN JOURNAL OF GASTROENTEROLOGY. 101(10). p.2341-2346
Author
Organization
Abstract
OBJECTIVES: Focal nodular hyperplasia-like nodules (FNH-like nodules) are focal lesions occurring in liver cirrhosis and are morphologically very similar to classical FNH in an otherwise normal liver. They are sometimes misdiagnosed as hepatocellular carcinoma (HCC) on imaging because both types of lesions show arterial-phase enhancement. Although the morphological, immunohistochemical, and imaging features of FNH-like nodules are well-known, their pathogenesis and role in hepatocarcinogenesis have not been studied in detail. Therefore, we performed a detailed pathological evaluation of 130 cirrhotic explant livers and correlated these data with the clinical features of the patients. METHODS: All cirrhotic explant livers were uniformly sliced at 5-mm intervals and all detected focal lesions were microscopically classified according to internationally accepted criteria. The obtained data regarding FNH-like nodules were then correlated with other pathological findings and with clinical data obtained during pretransplant evaluation and recorded in a database. RESULTS: FNH-like nodules were present in 15% of patients and their small size (75% of cases < 1 cm) appears to preclude detection by imaging in almost all cases. The presence of esophageal varices and pretransplant treatment with chemoembolization were independently and significantly associated with the presence of FNH-like nodules. There were no associations between FNH-like nodules on the one hand and low-grade dysplastic nodules, high-grade dysplastic nodules, and HCCs on the other hand. CONCLUSIONS: The clinicopathological features of FNH-like nodules support the hypothesis that vascular alterations in liver cirrhosis play an important role in their pathogenesis and that FNH-like nodules do not have an increased risk of malignant transformation.
Keywords
HELICAL CT, DYSPLASTIC NODULES, SHORT-TERM, LESIONS, THERAPY, PORTAL-HYPERTENSION, HEPATOCELLULAR-CARCINOMA, TRANSCATHETER ARTERIAL EMBOLIZATION

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MLA
Libbrecht, Louis, David Cassiman, Chris Verslype, et al. “Clinicopathological Features of Focal Nodular Hyperplasia-like Nodules in 130 Cirrhotic Explant Livers.” AMERICAN JOURNAL OF GASTROENTEROLOGY 101.10 (2006): 2341–2346. Print.
APA
Libbrecht, L., Cassiman, D., Verslype, C., Maleux, G., Van Hees, D., Pirenne, J., Nevens, F., et al. (2006). Clinicopathological features of focal nodular hyperplasia-like nodules in 130 cirrhotic explant livers. AMERICAN JOURNAL OF GASTROENTEROLOGY, 101(10), 2341–2346.
Chicago author-date
Libbrecht, Louis, David Cassiman, Chris Verslype, Geert Maleux, Dirk Van Hees, Jacques Pirenne, Frederik Nevens, and Tania Roskams. 2006. “Clinicopathological Features of Focal Nodular Hyperplasia-like Nodules in 130 Cirrhotic Explant Livers.” American Journal of Gastroenterology 101 (10): 2341–2346.
Chicago author-date (all authors)
Libbrecht, Louis, David Cassiman, Chris Verslype, Geert Maleux, Dirk Van Hees, Jacques Pirenne, Frederik Nevens, and Tania Roskams. 2006. “Clinicopathological Features of Focal Nodular Hyperplasia-like Nodules in 130 Cirrhotic Explant Livers.” American Journal of Gastroenterology 101 (10): 2341–2346.
Vancouver
1.
Libbrecht L, Cassiman D, Verslype C, Maleux G, Van Hees D, Pirenne J, et al. Clinicopathological features of focal nodular hyperplasia-like nodules in 130 cirrhotic explant livers. AMERICAN JOURNAL OF GASTROENTEROLOGY. 2006;101(10):2341–6.
IEEE
[1]
L. Libbrecht et al., “Clinicopathological features of focal nodular hyperplasia-like nodules in 130 cirrhotic explant livers,” AMERICAN JOURNAL OF GASTROENTEROLOGY, vol. 101, no. 10, pp. 2341–2346, 2006.
@article{3183549,
  abstract     = {OBJECTIVES: Focal nodular hyperplasia-like nodules (FNH-like nodules) are focal lesions occurring in liver cirrhosis and are morphologically very similar to classical FNH in an otherwise normal liver. They are sometimes misdiagnosed as hepatocellular carcinoma (HCC) on imaging because both types of lesions show arterial-phase enhancement. Although the morphological, immunohistochemical, and imaging features of FNH-like nodules are well-known, their pathogenesis and role in hepatocarcinogenesis have not been studied in detail. Therefore, we performed a detailed pathological evaluation of 130 cirrhotic explant livers and correlated these data with the clinical features of the patients. 
METHODS: All cirrhotic explant livers were uniformly sliced at 5-mm intervals and all detected focal lesions were microscopically classified according to internationally accepted criteria. The obtained data regarding FNH-like nodules were then correlated with other pathological findings and with clinical data obtained during pretransplant evaluation and recorded in a database. 
RESULTS: FNH-like nodules were present in 15% of patients and their small size (75% of cases < 1 cm) appears to preclude detection by imaging in almost all cases. The presence of esophageal varices and pretransplant treatment with chemoembolization were independently and significantly associated with the presence of FNH-like nodules. There were no associations between FNH-like nodules on the one hand and low-grade dysplastic nodules, high-grade dysplastic nodules, and HCCs on the other hand. 
CONCLUSIONS: The clinicopathological features of FNH-like nodules support the hypothesis that vascular alterations in liver cirrhosis play an important role in their pathogenesis and that FNH-like nodules do not have an increased risk of malignant transformation.},
  author       = {Libbrecht, Louis and Cassiman, David and Verslype, Chris and Maleux, Geert and Van Hees, Dirk and Pirenne, Jacques and Nevens, Frederik and Roskams, Tania},
  issn         = {0002-9270},
  journal      = {AMERICAN JOURNAL OF GASTROENTEROLOGY},
  keywords     = {HELICAL CT,DYSPLASTIC NODULES,SHORT-TERM,LESIONS,THERAPY,PORTAL-HYPERTENSION,HEPATOCELLULAR-CARCINOMA,TRANSCATHETER ARTERIAL EMBOLIZATION},
  language     = {eng},
  number       = {10},
  pages        = {2341--2346},
  title        = {Clinicopathological features of focal nodular hyperplasia-like nodules in 130 cirrhotic explant livers},
  url          = {http://dx.doi.org/10.1111/j.1572-0241.2006.00783.x},
  volume       = {101},
  year         = {2006},
}

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