Macroregenerative nodules and hepatocellular carcinoma in forty-four sequential adult liver explants with cirrhosis
✍ Scribed by Neil D. Theise; Myron Schwartz; Charles Miller; Swan N. Thung
- Publisher
- John Wiley and Sons
- Year
- 1992
- Tongue
- English
- Weight
- 722 KB
- Volume
- 16
- Category
- Article
- ISSN
- 0270-9139
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✦ Synopsis
Macroregenerative nodules, also called nodules of adenomatous hyperplasia, have been well documented in Japan. Extensive studies support the hypothesis that in the Japanese population these lesions represent a pogeible pathway for hepatocarcinogenesis.
However, reporting of these lesions in non-Japanese populationm has so far been rare. We examined 44 sequemtial cirrhotic hepatectomy specimens from adult patients who underwent orthotopic liver trans- plantation at our institution. All livers were serially 88ctioned every 0.5 cm. Macroregenerative nodules were defined am regenerative nodules at least 1 cm in diameter. Forty-eight macroregenerative nodules were found in 11 livers (26% of livers). The antecedent diseasem in these livers included hepatitis C (3). alcoholism (a), primary biliary cirrhosis (2) (one with iron overload), cryptogenic cirrhosis (2), hepatitis B (1) and u,-antitryprdn ddciency (1). The macroregenerative nodalee often differed from the surrounding nodular parenchyma in color, texture or the degree to which they bulged beyond the cut liver surface. Three livers contained grossly apparent hepatocellular carcinomas. Microscopically, macroregenerative nodules could be clamifled as those with (type 2) and without (type 1) dysplasia. Four livers had type 1 lesions, two had type 2 lesions and five had lesions of both types. We found 36 type 1 lesions in all and 12 type 2 lesions, 3 containing foci of microscopic carcinoma. All hepatocellular carcinomas arose in livers containing macroregenerative nodules (either type). Liver cell dysplasia, large-cell or small-cell, was o b r v e d in cirrhotic nodules of 27 livers. Microscopic or macroscopic