Liver mass pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Iqra Qamar M.D.[2]

Overview

Pathophysiology

Genetics

Associated Conditions

Gross Pathology

Pathogeneis Genetics Associated conditions Gross Pathology Microscopic Pathology
Hepatocellular adenoma
  • Estrogens cause the transformation of hepatocytes via steroid receptors
  • Results in generalized vascular ectasia
  • Transcription factor 1 gene (TCF1)
  • Interleukin 6 signal transducer gene (IL6ST)
  • β catenin-1 gene (CTNNB1)
  • Glycogen storage disease types Ia and III
  • Fanconi anemia
  • Thalassemia
  • Familial adenomatous polyposis
  • Familial diabetes mellitus
  • Hurler disease
  • Galactosemia
  • Well circumscribed
  • Nonlobulated
  • Smooth and soft
  • White to yellow to brown lesions
  • Cords of hepatocytes that have a high glycogen and fat content
  • Lack of normal hepatic parenchymal architecture
  • Absence of portal tracts and hepatic veins
Focal nodular hyperplasia
  • Develop around a preexisting arterial malformation
  • Hyperplastic growth response to parenchymal blood flow
  • β-catenin gene (CTNNB1)
  • TP53
  • APC or HNF1α
  • Klippel-Trénaunay-Weber syndrome
  • Well-circumscribed
  • Non-encapsulated
  • Central fibrous scar
  • Hepatic parenchyma arranged in incomplete nodules
  • Fibrous tissue with thick-walled vessels
  • Bile ductular proliferation
  • Cells of chronic inflammation
Intrahepatic bileduct cystadenoma
Hemangioma
  • Congenital disorder
  • Vascular malformations that enlarge by ectasia 
  • Estrogen and progesterone influence over tumor growth
  • More common in females
  • Von Hippel Lindau disease
  • Well-circumscribed
  • Appear red-brown
  • Solitary nodules
  • Less than 5cms
  • Large cystically dilated vessels
  • Thin walls
  • Intravascular thrombosis
  • Calcifications
Lymphangioma
Lymphangiomatosis
Angiomyolipoma
Infantile Hemangioma
HCC
Cholangiocarcinoma
Hepatic abscess
Parasitic cysts

Microscopic Pathology

References

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