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
H-HCALack of LFABP → H-HCA
(iv) Inflammation
(v) Sinusoidal dilatation
(vi) Pseudoportal tracts (with thick arteries)
(vii) Ductular reaction
IHCA*CRP/or SAA + → IHCA
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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