Hepatocellular adenoma pathophysiology: Difference between revisions
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On gross pathology, well circumscribed, nonlobulated, smooth and soft, and white to yellow to brown lesions are findings of a solitary hepatocellular adenoma.<ref name="pmid18333188">{{cite journal| author=Barthelmes L, Tait IS| title=Liver cell adenoma and liver cell adenomatosis. | journal=HPB (Oxford) | year= 2005 | volume= 7 | issue= 3 | pages= 186-96 | pmid=18333188 | doi=10.1080/13651820510028954 | pmc=PMC2023950 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18333188 }} </ref><ref name="pmid11452062">{{cite journal| author=Grazioli L, Federle MP, Brancatelli G, Ichikawa T, Olivetti L, Blachar A| title=Hepatic adenomas: imaging and pathologic findings. | journal=Radiographics | year= 2001 | volume= 21 | issue= 4 | pages= 877-92; discussion 892-4 | pmid=11452062 | doi=10.1148/radiographics.21.4.g01jl04877 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11452062 }} </ref> On microscopic histopathological analysis, cords of hepatocytes that have a high glycogen and fat content, lack of normal hepatic parenchymal architecture, and an absence of portal tracts and hepatic veins are characteristic findings of hepatocellular adenoma.<ref name="pmid18333188">{{cite journal| author=Barthelmes L, Tait IS| title=Liver cell adenoma and liver cell adenomatosis. | journal=HPB (Oxford) | year= 2005 | volume= 7 | issue= 3 | pages= 186-96 | pmid=18333188 | doi=10.1080/13651820510028954 | pmc=PMC2023950 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18333188 }} </ref> | On gross pathology, well circumscribed, nonlobulated, smooth and soft, and white to yellow to brown lesions are findings of a solitary hepatocellular adenoma.<ref name="pmid18333188">{{cite journal| author=Barthelmes L, Tait IS| title=Liver cell adenoma and liver cell adenomatosis. | journal=HPB (Oxford) | year= 2005 | volume= 7 | issue= 3 | pages= 186-96 | pmid=18333188 | doi=10.1080/13651820510028954 | pmc=PMC2023950 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18333188 }} </ref><ref name="pmid11452062">{{cite journal| author=Grazioli L, Federle MP, Brancatelli G, Ichikawa T, Olivetti L, Blachar A| title=Hepatic adenomas: imaging and pathologic findings. | journal=Radiographics | year= 2001 | volume= 21 | issue= 4 | pages= 877-92; discussion 892-4 | pmid=11452062 | doi=10.1148/radiographics.21.4.g01jl04877 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11452062 }} </ref> On microscopic histopathological analysis, cords of hepatocytes that have a high glycogen and fat content, lack of normal hepatic parenchymal architecture, and an absence of portal tracts and hepatic veins are characteristic findings of hepatocellular adenoma.<ref name="pmid18333188">{{cite journal| author=Barthelmes L, Tait IS| title=Liver cell adenoma and liver cell adenomatosis. | journal=HPB (Oxford) | year= 2005 | volume= 7 | issue= 3 | pages= 186-96 | pmid=18333188 | doi=10.1080/13651820510028954 | pmc=PMC2023950 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18333188 }} </ref> | ||
==Pathophysiology== | ==Pathophysiology== | ||
* The exact pathogenesis of hepatocellular adenoma is still unknown, however, its association with oral contraceptive use is well established. | |||
* In 1973, Baum et al first described the causal association of hepatocellular adenoma with oral contraceptive use. | |||
* In 1979, Rooks et al reported the relationship with oral contraceptive use to be dose and duration dependent and is highest in women over 30 years of age after using oral contraceptive for more than 24 months. | |||
* Hepatocellular adenoma has also been associated with long term use of anabolic androgenic steroids and glycogen storage diseases. | |||
* Other rare causal associations include; familial adenomatous polyposis, maturity onset diabetes of young, obesity, metabolic syndrome and vascular disorders like portal vein agenesis, budd chiari syndrome and hereditary hemmorhagic telangeictasia. | |||
==Genetics== | ==Genetics== | ||
The pathogenesis of hepatocellular adenoma usually involves the Wnt signalling pathway. | The pathogenesis of hepatocellular adenoma usually involves the Wnt signalling pathway. | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Nawal Muazam M.D.[2]
Overview
On gross pathology, well circumscribed, nonlobulated, smooth and soft, and white to yellow to brown lesions are findings of a solitary hepatocellular adenoma.[1][2] On microscopic histopathological analysis, cords of hepatocytes that have a high glycogen and fat content, lack of normal hepatic parenchymal architecture, and an absence of portal tracts and hepatic veins are characteristic findings of hepatocellular adenoma.[1]
Pathophysiology
- The exact pathogenesis of hepatocellular adenoma is still unknown, however, its association with oral contraceptive use is well established.
- In 1973, Baum et al first described the causal association of hepatocellular adenoma with oral contraceptive use.
- In 1979, Rooks et al reported the relationship with oral contraceptive use to be dose and duration dependent and is highest in women over 30 years of age after using oral contraceptive for more than 24 months.
- Hepatocellular adenoma has also been associated with long term use of anabolic androgenic steroids and glycogen storage diseases.
- Other rare causal associations include; familial adenomatous polyposis, maturity onset diabetes of young, obesity, metabolic syndrome and vascular disorders like portal vein agenesis, budd chiari syndrome and hereditary hemmorhagic telangeictasia.
Genetics
The pathogenesis of hepatocellular adenoma usually involves the Wnt signalling pathway.
Gross Pathology
On gross pathology, well circumscribed, nonlobulated, smooth and soft, and white to yellow to brown lesions are findings of a solitary hepatocellular adenoma.[1][2]
Microscopic Pathology
On microscopic histopathological analysis, cords of hepatocytes that have a high glycogen and fat content, lack of normal hepatic parenchymal architecture, and an absence of portal tracts and hepatic veins are characteristic findings of hepatocellular adenoma.[1]
-
![Low magnification micrograph of a hepatic adenoma. H&E stain.[3]](/images/9/90/Hepatic_adenoma_low_magnification.jpg)
Low magnification micrograph of a hepatic adenoma. H&E stain.[3]
-
![High magnification micrograph of a hepatic adenoma. H&E stain.[4]](/images/4/42/Hepatocellular_adenoma_high_magnification.jpg)
High magnification micrograph of a hepatic adenoma. H&E stain.[4]
![Low magnification micrograph of a hepatic adenoma. H&E stain.[3]](/index.php/File:Hepatic_adenoma_low_magnification.jpg)
![High magnification micrograph of a hepatic adenoma. H&E stain.[4]](/index.php/File:Hepatocellular_adenoma_high_magnification.jpg)
References
- ↑ 1.0 1.1 1.2 1.3 Barthelmes L, Tait IS (2005). "Liver cell adenoma and liver cell adenomatosis". HPB (Oxford). 7 (3): 186–96. doi:10.1080/13651820510028954. PMC 2023950. PMID 18333188.
- ↑ 2.0 2.1 Grazioli L, Federle MP, Brancatelli G, Ichikawa T, Olivetti L, Blachar A (2001). "Hepatic adenomas: imaging and pathologic findings". Radiographics. 21 (4): 877–92, discussion 892-4. doi:10.1148/radiographics.21.4.g01jl04877. PMID 11452062.
- ↑ Hepatic adenoma. Librepathology (2015). http://librepathology.org/wiki/index.php/File:Hepatic_adenoma_low_mag.jpg Accessed on November 3, 2015
- ↑ Hepatic adenoma. Librepathology (2015). http://librepathology.org/wiki/index.php/File:Hepatic_adenoma_high_mag.jpg Accessed on November 7, 2015
