Pictures of focal nodular hyperplasia and hepatocellular adenomas

Figure 7 HNF1a inactivated hepatocellular adenoma microscopic atypical feature. A, B: Woman born in 1952; abnormal liver function tests; oral contraceptives 13 years; BMI 25.4; magnetic resonance imaging (MRI): adenomatosis, largest nodule 6 cm. Segmentectomy IV/VI in 2001. A: ill defined nodule composed of clear hepatocytes, with mild steatosis. B: Same nodule seen at a higher magnification. The normal portal tract from the periphery of non tumoral parenchyma is entrapped in the nodule. The diagnosis of HNF1A mutated hepatocellular adenoma (H-HCA) is less evident than in Figure 6B, C. The diagnosis was confirmed by immunohistochemistry. C, D: Woman born in 1950; abnormal liver function tests; imaging: probable FNH 12 cm. Right hepatectomy 2002. HE: proliferation of benign hepatocytes, no steatosis, mild sinusoidal dilatation. This is a rare case. The diagnosis of H-HCA cannot be suspected without performing immunohistochemistry. E, F: Woman born in 1965; past history of cancer. Abdominal pain. Oral contraceptives 10 years, BMI 21 kg/m². MRI: Adenomatosis, largest nodule 3.9 cm. Segmentectomy and tumorectomy in 2011. HE: Proliferation of benign hepatocytes, no steatosis, mild sinusoidal dilatation, numerous ectatic vessels. As above, in this rare case the diagnosis of H-HCA cannot be suspected without immunohistochemistry, and malignant transformation has to be ruled out.