18-8: Nodules and Tumors Flashcards
what are the benign hepatic masses?
nodular hyperplasias
hemangiomas
adenomas
what are the malignant hepatic masses?
hepatoblastoma
hepatocellular carcinoma
cholangiocarcinoma
angiosarcoma
lymphoma
metastatic
what is focal nodular hyperplasia?
a single well-demarcated lesion with central scar
incidental finding in otherwise normal liver
map-like pattern of strong cytoplasmic GS staining
what conditions are associated with FNH?
hepatic or extra-hepatic hemangioma
vascular malformations
some brain tumors
what is nodular regenerative hyperplasia?
multiple nodules that resemble cirrhosis however there is no fibrous septa
risk of portal hypertension
what conditions are associated with NRH?
HIV
rheumatologic disease
what is the most common benign neoplasm of the liver?
cavernous hemangioma
what is the presentation of cavernous hemangioma?
F > M
usually asymptomatic and incidental discovery
risk of hemorrhage due to subcapsular location
what is the presentation of hepatocellular adenoma?
F > M
associated with oral contraceptives and anabolic steroids
increased incidence with obesity and metabolic syndrome
usually an incidental finding on imaging but may be found due to rapid growth or hemorrhage
what are the adenoma subtypes?
HNF1-a inactivated adenoma
Inflammatory adenoma
B-Catenin activated adenoma
HNF1-a inactivated adenoma
strong female predilection
fatty tumor without atypia
minimal risk of malignant transformation
Inflammatory adenoma
strongly associated with females and obesity/metabolic syndrome
overexpress CRP and amyloid A
risk for malignant transformation
B-Catenin activated adenoma
40% occur in men
associated with oral contraceptives and anabolic steroids
high risk for malignant transformation
what is the clinical presentation of hepatoblastoma?
< 3 years old
asymptomatic abdominal swelling
occasionally presents with jaundice and pruritis
what are the histological features of the epithelial type hepatoblastoma?
small polygonal fetal cells or smaller embryonal cells forming acini, tubules or papillary structures