Hepatocellular carcinoma associated with focal nodular hyperplasia

Chen, Tse–Ching; Chou, Tze-Bin; Ng, Kwai‐Fong; Hsieh, Ling–Ling; Chou, Yah‐Huei Wu

doi:10.1007/s004280000348

Cited by 36 publications

(24 citation statements)

References 10 publications

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“…TGF-β initiates signaling through heteromeric complexes of transmembrane type I and type II serine/threonine kinase receptors [5]. Activated TGF-β type I receptor phosphorylates receptor-regulated Smads [2,4]. However, genetic alterations of the TGF-β pathway are mediated by mutations of the Smad2 and Smad4 gene, which occur in about 10% of HCC cases.…”

Section: Alterations Of the Tgf-β/igf-axismentioning

confidence: 99%

Genes involved in hepatocellular carcinoma: deregulation in cell cycling and apoptosis

Tannapfel

Wittekind

2002

Virchows Arch

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Hepatocellular carcinoma (HCC) accounts for 80-90% of liver cancers and is one of the most frequent carcinomas throughout the world. The disease is more prevalent in parts of Africa and Asia than in North and South America and Europe, with a strong etiological association with viral hepatitis, hemochromatosis, known liver (hepatic) carcinogens, and toxins (mycotoxins). Clinical and molecular medical analyses have yielded a considerable amount of information about liver carcinogenesis. Many genes undergo somatic aberrations, with a tendency to cluster at genes involved in cell cycle regulation, in the p53 and Wnt/catenin pathways of signal transduction and cellular adhesion, and in the TGF-beta/IGF axis. Since HCC may arise both in liver cirrhosis and in noncirrhotic liver, one may speculate that different hepatocarcinogenetic pathways exist. Recent results of high-output gene analysis using cDNA microarrays support the idea of different genetic alterations in HCC with or without cirrhosis.

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Section: Alterations Of the Tgf-β/igf-axismentioning

confidence: 99%

Genes involved in hepatocellular carcinoma: deregulation in cell cycling and apoptosis

Tannapfel

Wittekind

2002

Virchows Arch

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“…5 Convincing histological evidence of the transformation of FNH to hepatocellular carcinoma does not exist, and studies of clonal analysis have rejected the potential for malignant transformation within FNH to hepatocellular carcinoma. Ewing's sarcoma metastasising to FNH has also been described.…”

Section: Discussionmentioning

confidence: 99%

Metastatic rectal adenocarcinoma to the liver associated with focal nodular hyperplasia

Nisar

Zaitoun²,

Damera³

et al. 2002

Journal of Clinical Pathology

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A 45 year old female patient underwent right hemihepatectomy for metastatic rectal adenocarcinoma. Preoperative imaging demonstrated an area of focal nodular hyperplasia (FNH) in segment VIII and metastatic carcinoma in segment VI of the liver. Gross and microscopic examination of the former lesion showed features typical of FNH with an intralesional metastatic adenocarcinoma. To the best of our knowledge, this is the first reported case of metastatic adenocarcinoma located within a lesion of FNH. The possibility of a pathogenetic association behind this occurrence is discussed.A previously well 43 year old female patient underwent anterior resection for Dukes's stage C1 adenocarcinoma of the rectum. Postoperatively, she received adjuvant chemotherapy for six months. Liver ultrasonography at one year follow up demonstrated an irregular hypoechoic lesion measuring 25 mm in diameter and extensive fatty change.After referral to a liver surgeon, contrast enhanced magnetic resonance imaging (MRI) was performed. This demonstrated a 34 mm circular hypervascular mass in segment VIII of the liver (lesion A) with decreased signal on T1 and T2 weighted images, showing early and persistent enhancement. The mass contained an eccentric low attenuation area on dynamic imaging, which was suggestive of a scar within an area of focal nodular hyperplasia (FNH). A 15 mm non-enhancing spherical lesion in segment VI was demonstrated (lesion B), which did not conclusively represent a metastatic focus.After an interval of three months MRI was repeated. Lesion B had grown to 35 mm in diameter and showed irregular rim enhancement with reduced signal on T1 and T2 weighted images; features that are typical of neoplastic disease. The patient was admitted for elective right hemihepatectomy. The patient recovered without complications and was discharged. PATHOLOGY MacroscopyThe resected specimen weighed a total of 1056 g and measured 21 × 17 × 9 cm. A well circumscribed unencapsulated tumour (lesion B), which measured 2.7 × 2.2 × 2 cm, was present at 2 cm from the resection margin in liver segment VI. Lesion A measured 5 × 3 × 4 cm, and was situated in segment VIII, 6.5 cm from lesion B, so that it extended closely (0.3 cm) to the margin of resection.Lesion A had an ill defined, lobulated, flesh coloured, nodular appearance when sectioned, and contained a central scar, surrounded by irradiating fibrous septa-a picture typical of FNH. A solid white tumour measuring 1 × 1 × 0.7 cm was seen arising within the main mass of FNH ( fig 1A). More than 80% of the metastatic tumour nodule was surrounded by the FNH and the remaining outline was composed of fibrous capsule. MicroscopyMicroscopic examination of lesion A revealed nodular hyperplastic parenchyma showing thickened hepatic plates and prominent tortuous vessels of arteriolar calibre (fig 1B), consistent with FNH.

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“…Clonal analysis using the HUMARA test demonstrated the reactive polyclonal nature of liver cells in FNH in 50 to 100% of the cases, depending on the series (15)(16)(17)(18)(19) (Table 1). Other studies analyzing chromosome gains and losses by comparative genomic hybridization, allelotyping, or karyotype identified chromosome alterations, indicating a clonal origin of the FNH nodules in 14 to 50% of the cases (19)(20)(21)(22)(23) (Table 1).…”

Section: -Molecular Features Associated With Fnhmentioning

confidence: 99%

Hepatocellular Adenoma

Kirkegaard¹

2010

High-Yield Imaging: Gastrointestinal

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Hepatocellular carcinoma associated with focal nodular hyperplasia

Cited by 36 publications

References 10 publications

Genes involved in hepatocellular carcinoma: deregulation in cell cycling and apoptosis

Genes involved in hepatocellular carcinoma: deregulation in cell cycling and apoptosis

Metastatic rectal adenocarcinoma to the liver associated with focal nodular hyperplasia

Hepatocellular Adenoma

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