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| Adenoma |
| Etiology •The more common hepatocellular adenoma may be related to contraceptive use. |
| Pathogenesis •Unknown, |
| Epidemiology •The more common liver cell adenoma is common in young women and may be related to the use of oral contraceptives. •Bile duct adenomas are much less common and may represent hamartomas (developmental anomalies), rather than true adenomas. |
| General Gross Description •Hepatic adenomas are of two histological types: liver cell and bile duct. •Liver cell adenomas can be large (25-30 centimeters in diameter), while bile duct adenomas are usually small, up to one centimeter in diameter. •Liver cell adenomas can occur anywhere in the liver parenchyma, but are often seen under the capsule. •Liver cell adenomas are pale to yellow and may be bile stained. •They are usually well demarcated from the rest of the liver parenchyma, but the capsule may not be obvious. |
| General Microscopic Description •Histologically, a hepatocellular adenoma is composed of normal looking hepatocytes arranged in sheets and cords. •Significant evidence of bile deposition may be seen within and between the cells. •Typical portal tracts and central veins are not seen, since the cells are not arranged in a typical lobular pattern. •However, significant vascular supply is a prominent feature. •Bile duct adenomas are composed of slit-like to circular spaces lined by epithelium that resembles normal bile duct epithelium. |
| Clinical Correlation •Clinically, both liver cell adenomas and bile cell adenomas are benign lesions with little clinical significance. •However, liver cell adenomas can become large sized during pregnancy, presumably as a result of estrogen stimulation. •Under these circumstances, liver cell adenomas can rupture resulting in acute peritonitis. •A differential diagnosis of a liver cell adenoma is hepatocellular carcinoma. •Liver cell adenomas may regress in young women once they stop oral contraceptive ingestion. |
| References • Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 878 • Harrison's Principles of Internal Medicine, 13th Ed: Isselbach et. al. (eds). New York, McGraw-Hill, 1994, pp. 1495 |
| Adenoma |
| Synopsis by: T.V.Rajan, M.D., Ph.D. (T56000M81400)[505] |
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