Hepatocellular Adenomas in a Large Community Population 2000-2010: Reclassification Per Current WHO Classification and Long-Term Follow-Up
Gillian Genrich, Nafis Shafizadeh, Linda Ferrell, Sanjay Kakar. University of California San Francisco, San Francisco, CA; Southern California Permanente Medical Group, Woodland Hills, CA
Background: Data for WHO classification of hepatocellular adenoma (HA) is largely based on cases from tertiary care centers. This study examines distribution of HA subtypes in a community setting and determines the impact of immunohistochemistry (IHC) on reclassification, diagnosis, and management.
Design: All cases diagnosed as HA in a large community hospital from 2000-2010 were reviewed (n= 49) to confirm the diagnosis. Where tissue was available (n=35), IHC was performed for evaluation of HA: liver fatty acid binding protein (L-FABP), serum amyloid A (SAA), C-reactive protein(CRP), beta-catenin (bC), glutamine synthetase (GS), heat shock protein 70 (HSP70) and glypican-3 (GPC).
Results: There were 35 cases available for IHC evaluation. The reclassification of HAs was based on histopathologic and immunophenotypic features.
|HNF1alpha inactivated||9/35 (26%)|
|B-catenin activated/atypical||6/35 (17%)|
|Very Well-differentiated HCC||1/35 (3%)|
|Focal Nodular Hyperplasia||3/35 (9%)|
|Beta-catenin/atypical||Positive||Negative||Negative||+/- Membrane; Nuclear||Diffuse||Negative||Variable|