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Small mass lesions in cirrhosis: Transition from benign adenomatous hyperplasia to hepatocellular carcinoma?
Author(s) -
ARAKAWA MASAHIRO,
SUGIHARA SHIGETAKA,
KENMOCHI KUNIHIKO,
KAGE MASAYOSHI,
NAKASHIMA TOSHIRO,
NAKAYAMA TOSHIMICHI,
TASHIRO SEIKI,
HIRAOKA TAKEHISA,
SUENAGA MASAHIRO,
OKUDA KUNIO
Publication year - 1986
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.1986.tb01750.x
Subject(s) - medicine , hepatocellular carcinoma , cirrhosis , malignancy , atypical adenomatous hyperplasia , pathology , hyperplasia , carcinoma , focal nodular hyperplasia , cancer , gastroenterology , adenocarcinoma
Ten patients with cirrhosis, in whom small mass lesions were detected by imaging techniques and histological diagnosis of the resected specimens was difficult, are described. There were 17 grossly discrete lesions measuring 10 × 8 mm to 27 × 22 mm. Four were compatible with so‐called adenomatous hyperplasia showing no histological features of malignancy, and eight were equivocal as to whether they were benign or malignant. The other five lesions (in four patients) were hepatocellular carcinoma, co‐existing with apparently benign lesions. The eight equivocal lesions were eventually judged to be highly differentiated hepatocellular carcinomas. These benign‐appearing lesions, found by advanced imaging in patients with cirrhosis, create a serious problem in regions where primary liver cancer is endemic among cirrhotics, and hepatic resection is the preferred treatment. It is possible that these lesions represent a transition from adenomatous hyperplasia occurring in cirrhotic livers to hepatocellular carcinoma through a histologically equivocal state and that the current morphological methods are inadequate for differentiating malignant from benign lesions.