%0 Journal Article
%T Focal Nodular Hyperplasia and Hepatocellular Adenoma around the World Viewed through the Scope of the Immunopathological Classification
%A Charles Balabaud
%A Wesal R. Al-Rabih
%A Pei-Jer Chen
%A Kimberley Evason
%A Linda Ferrell
%A Juan C. Hernandez-Prera
%A Shiu-Feng Huang
%A Thomas Longerich
%A Young Nyun Park
%A Alberto Quaglia
%A Peter Schirmacher
%A Christine Sempoux
%A Swan N. Thung
%A Michael Torbenson
%A Aileen Wee
%A Matthew M. Yeh
%A Shiou-Hwei Yeh
%A Brigitte Le Bail
%A Jessica Zucman-Rossi
%A Paulette Bioulac-Sage
%J International Journal of Hepatology
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/268625
%X Focal nodular hyperplasia (FNH) and hepatocellular adenoma (HCA) are benign hepatocellular tumors. The risk of bleeding and malignant transformation of HCA are strong arguments to differentiate HCA from FNH. Despite great progress that has been made in the differential radiological diagnosis of the 2 types of nodules, liver biopsy is sometimes necessary to separate the 2 entities. Identification of HCA subtypes using immunohistochemical techniques, namely, HNF1A-inactivated HCA (35每40%), inflammatory HCA (IHCA), and beta-catenin-mutated inflammatory HCA (b-IHCA) (50每55%), beta-catenin-activated HCA (5每10%), and unclassified HCA (10%) has greatly improved the diagnostic accuracy of benign hepatocellular nodules. If HCA malignant transformation occurs in all HCA subgroups, the risk is by far the highest in the 汕-catenin-mutated subgroups (b-HCA, b-IHCA). In the coming decade the management of HCA will be more dependent on the identification of HCA subtypes, particularly for smaller nodules (<5ˋcm) in terms of imaging, follow-up, and resection. 1. Introduction The knowledge of benign hepatocellular tumors, that is, focal nodular hyperplasia (FNH) and hepatocellular adenoma (HCA), has considerably progressed in the last 10 years, thanks to molecular biology, followed by immunohistochemical applications. Following these advances, new classification is now largely used, first in France, and more recently in other European, American, and East countries. The aims of this study are (1) to make a brief general overview of these 2 entities [2每8]; (2) to report results of a survey through different academic centers in France and throughout the world; (3) to report applications of the molecular/immunohistochemical data and of the new HCA classification in practice through the Bordeaux experience. 2. A Brief Overview of Focal Nodular Hyperplasia and Hepatocellular Adenoma 2.1. Focal Nodular Hyperplasia It is the second most frequent benign liver nodule (after hemangioma), occurring in 0.8% of an adult autopsy population and has been reported in 0.6每3% of the general population. In 80每90% of cases, FNH is discovered in women in their third or fourth decade. In countries (i.e., China) where OC use has been less prevalent, FNH tends to be a lesion of adult men or children of either gender. FNH is solitary in 2/3 of cases. Most lesions are asymptomatic and are therefore discovered as incidental findings during surgery, autopsy, or imaging procedures for unrelated symptoms. Large lesions can present with abdominal pain or compression of adjacent organs. Reports of
%U http://www.hindawi.com/journals/ijh/2013/268625/