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©The Author(s) 2022.
World J Gastroenterol. Apr 14, 2022; 28(14): 1384-1393
Published online Apr 14, 2022. doi: 10.3748/wjg.v28.i14.1384
Published online Apr 14, 2022. doi: 10.3748/wjg.v28.i14.1384
Table 1 Morpho-molecular features of the subtypes of hepatocellular adenoma
Key pathogenesis | Histology | Immunohistochemical stains | Clinical features | |
H-HCA | HNF1A inactivating mutation: Negative regulation of glycolipid metabolism and L-FABP | Marked steatosis | L-FABP: Negative | Associated with maturity onset diabetes of the young (MODY3) and familial hepatic adenomatosis |
I-HCA | IL-6/JAK/STAT3 pathway mutations: (1) Constitutive activation of inflammatory pathway; and (2) Upregulation of acute reactants and hepatocellular proliferation | (1) Inflammatory infiltration; (2) Pseudoportal tracts; (3) Ductular reaction; and (4) Sinusoidal dilatation/ peliosis | SSA and CRP: Diffuse positive | Obesity, metabolic syndrome, glycogen storage disease, high alcohol consumption, inflammatory syndrome |
b-HCA | (1) CTNNB1 gene mutation: Activation of signaling pathway and upregulation of targeted genes including GS; and (2) Level of activation depends on mutation loci (Exon 3 Non-S45: Strong activation; S45: Weak activation, and T41: Moderate activation; Exon 7/8: Weak activation) | More atypical features: Pseudoacini and mild cytologic atypia | (1) β-catenin: Aberrant nuclear expression; and (2) GS: Positive | More in men, anabolic steroids use, glycogen storage disease, high risk of malignant transformation, and high risk of bleeding (exon 7/8) |
b-IHCA | Share the features of both b-HCA and I-HCA | |||
shHCA | INHBE-GLI1 gene fusion: Constitutive activation of Sonic hedgehog pathway | Hemorrhage | PTGSD and ASS1 | High risk of bleeding and obesity |
Unclassified | Not other specified | |||
Uncommon subtypes | Myxoid HCA, pigmented HCA, atypical HCA, I-ICA in cirrhotic liver |
- Citation: Wang X, Zhang X. Hepatocellular adenoma: Where are we now? World J Gastroenterol 2022; 28(14): 1384-1393
- URL: https://www.wjgnet.com/1007-9327/full/v28/i14/1384.htm
- DOI: https://dx.doi.org/10.3748/wjg.v28.i14.1384