Etiological analysis of focal nodular hyperplasia of the liver, with emphasis on similar abnormal vasculatures to nodular regenerative hyperplasia and idiopathic portal hypertension

Kondo, Fukuo; Nagao, Toshitaka; Sato, Takahiro; Tomizawa, M.; Kondō, Yōichirō; Matsuzaki, Osamu; Wada, Kodai; Wakatsuki, Susumu; Nagao, Kōichi; Tsubouchi, Hiroyuki; Kobayashi, Hiroshi; Yasumi, Kazuhiko; Tsukayama, Chotatsu; Suzuki, Makoto

doi:10.1016/s0344-0338(98)80117-9

Cited by 72 publications

(62 citation statements)

References 18 publications

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“…[2][3][4][5][6][7][8][9]32 Our study confirmed this trend. Liver tests as well as viral and neoplastic markers are usually normal in FNH patients, although slightly elevated GOT, GPT, ALP and GGT have been reported, [2][3][4][5][6][7][8][9]32 as it happened in 47.1% of our patients. Abbreviations: cGVHD = chronic GVHD; CI = confidential interval; F = female; FNH = focal nodular hyperplasia; HR = hazard ratio; HrT = hormone replacement therapy; HSCT = hematopoietic SCT; M = male; RT = radiotherapy.…”

Section: Resultssupporting

confidence: 87%

“…So far, FNH seems to have a benign and uncomplicated course: all the existing studies report that nodules generally do not change their size and characteristics with time. [2][3][4][5][6][7][8][9]32 In our case series, in 53% of patients, one or more additional lesions with the same or increased diameter were discovered on follow-up, without evidence of malignant transformation.…”

Section: Liver Fnh In Pediatric Transplanted Patients M Pillon Et Almentioning

confidence: 53%

“…18,19 Nowadays, the most widely accepted theory is that FNH is a hyperplastic response to hyperperfusion by the characteristic anomalous arteries found in the center of nodules. 9 The association of FNH with some congenital vascular diseases such as hereditary hemorrhagic telangiectasia 27 and hepatic hemangiomas 26 strengthens this hypothesis. FNH could also be an acquired condition, for instance, after a localized vascular injury primed by chemotherapy and RT.…”

Section: Resultsmentioning

confidence: 89%

“…4 In our study, one female was diagnosed with hepatic adenoma, which is known to be associated with FNH. 9 As malignant transformation from adenoma to hepatocellular carcinoma is rare but well documented, 24 she underwent surgical resection of the mass.…”

Section: Resultsmentioning

confidence: 99%

“…Neither complications nor malignant degenerations are described up to now, and the differential diagnosis includes hepatocellular adenoma and fibrolamellar hepatocellular carcinoma. 9,10 In this retrospective study, we analyzed the case series of FNH that occurred in children who underwent HSCT at our institution, with the aim to evaluate incidence, clinical characteristics and instrumental features and to identify the risk factors associated with its occurrence.…”

Section: Introductionmentioning

confidence: 99%

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Focal nodular hyperplasia of the liver: an emerging complication of hematopoietic SCT in children

Pillon

Carucci

Mainardi

et al. 2015

Bone Marrow Transplant

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Hepatic focal nodular hyperplasia (FNH) is a nonmalignant condition rarely affecting children previously treated for cancer, especially those who received hematopoietic SCT (HSCT). Some aspects of its pathogenesis still remain unclear and a strong association with specific risk factors has not yet been identified. We report here a single institution's case series of 17 patients who underwent HSCT and were diagnosed with FNH, analyzing retrospectively their clinical features and the radiological appearance of their hepatic lesions. We aimed to compare the diagnostic accuracy of ultrasound (US) and magnetic resonance imaging (MRI) and to explore the role of transient elastography (FibroScan) to evaluate the degree of hepatic fibrosis in FNH patients. Our analysis showed an association of FNH with age at transplant ⩽ 12 years (hazard ratio (HR) 9.10); chronic GVHD (HR 2.99); hormonereplacement therapy (HR 4.02) and abdominal radiotherapy (HR 4.37). MRI proved to be a more accurate diagnostic tool compared with US. Nine out of 12 patients who underwent FibroScan showed hepatic fibrosis. Our study points out that FNH is an emerging complication of HSCT, which requires a lifelong surveillance to follow its course in cancer patients.

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Section: Resultssupporting

confidence: 87%

Section: Liver Fnh In Pediatric Transplanted Patients M Pillon Et Almentioning

confidence: 53%

Section: Resultsmentioning

confidence: 89%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Focal nodular hyperplasia of the liver: an emerging complication of hematopoietic SCT in children

Pillon

Carucci

Mainardi

et al. 2015

Bone Marrow Transplant

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Approach to Gastrointestinal and Liver Diseases in Pregnancy

Saha

Reau

2015

Yamada' S Textbook of Gastroenterology

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Hepatic focal nodular hyperplasia in children previously treated for a solid tumor

Bouyn

Leclère

Raimondo

et al. 2003

Cancer

132

126

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BACKGROUNDThe detection of hepatic nodules, particularly in patients treated for a previous malignancy, raises a diagnostic dilemma. Focal nodular hyperplasia (FNH) of the liver is an uncommon, benign tumor in children and must be differentiated from malignant hepatic lesions. The etiology of FNH is obscure, and its pathogenesis is poorly understood. FNH may be a reaction to localized vascular abnormalities and circulatory disturbances. The goal of the current study was to identify risk factors for the occurrence of FNH in children who had received prior treatment for a malignant tumor.METHODSThe current retrospective study examined 14 cases of FNH in pediatric patients who previously had been treated for a malignancy. Diagnosis was based on clinical and radiologic findings and was proven histologically in four cases.RESULTSFNH lesions were discovered by chance during routine examination in 78% of patients. The incidence of FNH was particularly high in the current series (0.45%) compared with the incidence in the general pediatric population. High doses of alkylating agents (e.g., busulfan or melphalan), venoocclusive disease, and liver radiotherapy may be responsible for injury to the vascular endothelium and subsequent localized circulatory disturbances. FNH is characterized by the absence of complications after its detection; therefore, only close follow‐up is recommended.CONCLUSIONSFNH appears to be a late complication of an iatrogenic vascular disease in children with a history of malignancy. Cancer 2003;97:3107–13. © 2003 American Cancer Society.DOI 10.1002/cncr.11452

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Etiological analysis of focal nodular hyperplasia of the liver, with emphasis on similar abnormal vasculatures to nodular regenerative hyperplasia and idiopathic portal hypertension

Cited by 72 publications

References 18 publications

Focal nodular hyperplasia of the liver: an emerging complication of hematopoietic SCT in children

Focal nodular hyperplasia of the liver: an emerging complication of hematopoietic SCT in children

Approach to Gastrointestinal and Liver Diseases in Pregnancy

Hepatic focal nodular hyperplasia in children previously treated for a solid tumor

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