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Difference between revisions of "Hepatic adenoma"
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Hepatic_adenoma_high_mag.jpg | |||
| Width = | |||
| Caption = Hepatic adenoma. [[H&E stain]]. | |||
| Synonyms = hepatocellular adenoma | |||
| Micro = sheets or cords of cells with mild variation of cell and nuclear size; cords of cells up to 3 cells thick, vascular (large arteries, dilated thin-walled veins), +/-cytoplasmic clearing/pale (due to glycogen); negatives: no bile ducts, no portal tracts, no [[cirrhosis]] | |||
| Subtypes = inflammatory hepatic adenoma ([[AKA]] ''telangiectatic adenoma''), hepatocyte nuclear factor 1 alpha-mutated hepatic adenoma, beta-catenin-mutated hepatic adenoma, unclassified hepatic adenoma | |||
| LMDDx = [[hepatocellular carcinoma]] (well-differentiated), [[focal nodular hyperplasia]] | |||
| Stains = | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = well-circumscribed, typically subcapsular | |||
| Grossing = | |||
| Site = [[liver]] - see ''[[liver neoplasms]]'' | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = women +/-[[OCP]] use | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = uncommon | |||
| Bloodwork = | |||
| Rads = subcapsular, well-circumscribed | |||
| Endoscopy = | |||
| Prognosis = benign | |||
| Other = | |||
| ClinDDx = | |||
| Tx = | |||
}} | |||
'''Hepatic adenoma''', also known as '''hepatocellular adenoma''' (abbreviated '''HCA'''), is a benign [[liver neoplasms|neoplasm of the liver]]. | '''Hepatic adenoma''', also known as '''hepatocellular adenoma''' (abbreviated '''HCA'''), is a benign [[liver neoplasms|neoplasm of the liver]]. | ||
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Features:<ref>STC S.20, 19 Jan 2009.</ref> | Features:<ref>STC S.20, 19 Jan 2009.</ref> | ||
*Often subcapsular location. | *Often subcapsular location. | ||
*Well circumscribed, but not encapsulated. | *Well-circumscribed, but not encapsulated. | ||
==Microscopic== | ==Microscopic== | ||
Features: | Features: | ||
*Sheets or cords of cells with mild variation of cell and nuclear size.<ref name=Ref_PBoD923>{{Ref PBoD|923}}</ref> | *Sheets or cords of cells with mild variation of cell and nuclear size.<ref name=Ref_PBoD923>{{Ref PBoD|923}}</ref> | ||
*Cords of cells | *Cords of cells up to 3 cells thick.<ref>STC S.19, 19 Jan 2009.</ref> | ||
*Cells may have cytoplasmic clearing due to glycogen or be pale - '''obvious if seen'''. | *Cells may have cytoplasmic clearing due to glycogen or be pale - '''obvious if seen'''. | ||
*Vascular - large arteries, dilated thin-walled veins. | *Vascular - large arteries, dilated thin-walled veins. | ||
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*No bile ducts. | *No bile ducts. | ||
*No portal tracts. | *No portal tracts. | ||
*No cirrhosis! If cirrhosis is present it isn't a hepatic adenoma - '''important'''. | *No [[cirrhosis]]! If cirrhosis is present it isn't a hepatic adenoma - '''important'''. | ||
DDx: | DDx: | ||
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===Images=== | ===Images=== | ||
<gallery> | <gallery> | ||
Image: | Image:Hepatic adenoma low mag.jpg | Low mag. (WC/Nephron) | ||
Image:Hepatic_adenoma_low_mag_reticulin.jpg | | Image:Hepatic_adenoma_high_mag.jpg | High mag. (WC/Nephron) | ||
Image:Hepatic_adenoma_low_mag_reticulin.jpg | Low mag. - reticulin (WC/Nephron) | |||
Image:Hepatic_adenoma_high_mag_reticulin.jpg | High mag. - reticulin (WC/Nephron) | |||
</gallery> | </gallery> | ||
www: | www: | ||
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==IHC== | ==IHC== | ||
*AFP -ve. (???) | *[[AFP]] -ve. (???) | ||
*HNF1alpha +ve/-ve. | *HNF1alpha +ve/-ve. | ||
*Beta-catenin +ve/-ve. | *Beta-catenin +ve/-ve. | ||
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==See also== | ==See also== | ||
*[[Liver neoplasms]]. | *[[Liver neoplasms]]. | ||
*[[Hepatocellular carcinoma]]. | |||
==References== | ==References== | ||