International Journal of Hepatology / 2013 / Article / Tab 2

Research Article

Value and Limits of Routine Histology Alone or Combined with Glutamine Synthetase Immunostaining in the Diagnosis of Hepatocellular Adenoma Subtypes on Surgical Specimens

Table 2

Phenotypic classification of hepatocellular adenoma: routine histology and immunohistochemistry (IHC) and molecular biology.

Routine histologyIn favor ofIHC

(i) Diffuse steatosis
(ii) Lobulated contour (surgical specimen)
(iii) No criteria for IHCA
(iv) Inflammation
(v) Sinusoidal dilatation
(vi) Pseudoportal tracts (with thick arteries)
(vii) Ductular reaction
CRP/or SAA +/GS**+ → b-IHCA
GS**  + (CRP−) → b-HCA
All markers− → UHCA

In the absence of typical routine histological criteria for H-HCA or IHCA, the other HCA subtypes are likely *include b-IHCA (GS is mandatory to differentiate IHCA and b-IHCA).
 **Perform in addition β-catenin staining: aberrant nuclear staining confirm the diagnosis; its absence does not rule out; however, the diagnosis, particularly on needle biopsies, needs molecular biology for definite diagnosis.

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