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International Journal of Hepatology
Volume 2013 (2013), Article ID 398308, 8 pages
http://dx.doi.org/10.1155/2013/398308
Clinical Study

Histological and Immunohistochemical Revision of Hepatocellular Adenomas: A Learning Experience

1Service d'Anatomie Pathologique, Cliniques Universitaires Saint-Luc, UCL, Avenue Hippocrate, 10, 1200 Brussels, Belgium
2Service de Chirurgie, Cliniques Universitaires Saint-Luc, UCL, 1200 Brussels, Belgium
3Service de Radiologie, Cliniques Universitaires Saint-Luc, UCL, 1200 Brussels, Belgium

Received 3 October 2012; Accepted 19 January 2013

Academic Editor: Charissa Chang

Copyright © 2013 S. Fonseca et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Light has been shed on the genotype/phenotype correlation in hepatocellular adenoma (HCA) recognizing HNF1α-inactivated HCA (H-HCA), inflammatory HCA (IHCA), and β-catenin-activated HCA (b-HCA). We reviewed retrospectively our surgical HCA series to learn how to recognize the different subtypes histopathologically and how to interpret adequately their immunohistochemical staining. From January 1992 to January 2012, 37 patients underwent surgical resection for HCA in our institution. Nine had H-HCA (25%) characterized by steatosis and loss of L-FABP expression; 20 had IHCA (55.5%) showing CRP and/or SAA expression, sinusoidal dilatation, and variable inflammation; and 1 patient had both H-HCA and IHCA. In 5 patients (14%), b-HCA with GS and β-catenin nuclear positivity was diagnosed, two already with hepatocellular carcinoma. Two cases (5.5%) remained unclassified. One of the b-HCA showed also the H-HCA histological and immunohistochemical characteristics suggesting a subgroup of β-catenin-activated/HNF1α-inactivated HCA, another b-HCA exhibited the IHCA histological and immunohistochemical characteristics suggesting a subgroup of β-catenin-activated/inflammatory HCA. Interestingly, three patients had underlying vascular abnormalities. Using the recently published criteria enabled us to classify histopathologically our retrospective HCA surgical series with accurate recognition of b-HCA for which we confirm the higher risk of malignant transformation. We also underlined the association between HCA and vascular abnormalities.