A 25-Year-Old Man with a Large Hepatic Tumor and Multiple Nodular Lesions

Fotis Iordanidis; Prodromos Hytiroglou; Antonios Drevelegas; Fotis Kodonas; Ioannis Ioannidis; Helen Nenopoulou; Constantine S. Papadimitriou

doi:10.1055/s-2002-23209

Seminars in Liver Disease, Inhaltsverzeichnis

Semin Liver Dis 2002; 22(1): 097-102
DOI: 10.1055/s-2002-23209

DIAGNOSTIC PROBLEMS IN HEPATOLOGY

A 25-Year-Old Man with a Large Hepatic Tumor and Multiple Nodular Lesions

Fotis Iordanidis¹ , Prodromos Hytiroglou¹ , Antonios Drevelegas² , Fotis Kodonas³ , Ioannis Ioannidis² , Helen Nenopoulou¹ , Constantine S. Papadimitriou¹

¹Department of Pathology, Aristotle University Medical School, Thessaloniki, Greece
²Department of Radiology, Aristotle University Medical School, Thessaloniki, Greece
³Department of Surgery, Aristotle University Medical School, Thessaloniki, Greece

Abstract

ABSTRACT

A 25-year-old man without a prior history of liver disease presented with an 18-cm tumor of the right hepatic lobe, which was associated with multiple nodular lesions in the remaining parenchyma. The histologic and immunohistochemical features of the neoplasm were those of a poorly differentiated leiomyosarcoma with epithelioid features. The nodular lesions measured up to 4 cm in greatest dimension and had gross and microscopic features of focal nodular hyperplasia. This case suggests that multiple focal nodular hyperplasia may occasionally represent a parenchymal reaction to abnormal blood supply developing within the liver as a consequence of an enlarging malignant tumor.

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Referenzen

REFERENCES

1 Anthony P P. Tumours and tumour-like lesions of the liver and biliary tract. In: MacSween RNM, Anthony PP, Scheuer PJ, et al, eds. Pathology of the Liver, 3rd ed Edinburgh: Churchill Livingston, 1994: 635-711
2 Craig J R, Peters R L, Edmondson H A. Tumors of the liver and intrahepatic bile ducts. In: Atlas of Tumor Pathology 2nd series. Fascicle 26. Washington, DC: Armed Forces Institute of Pathology 1989
3 Hytiroglou P, Theise N D. Differential diagnosis of hepatocellular nodular lesions. Semin Diagn Pathol . 1998; 15 285-299
4 International Working Party. Terminology of nodular hepatocellular lesions. Hepatology . 1995; 22 983-993
5 Wanless I R, Mawdsley C, Adams R. On the pathogenesis of focal nodular hyperplasia of the liver. Hepatology . 1985; 5 1194-1200
6 Nguyen B N, Flejou J-F, Terris B. Focal nodular hyperplasia of the liver. A comprehensive pathologic study of 305 lesions and recognition of new histologic forms. Am J Surg Pathol . 1999; 23 1441-1454
7 Saul S H, Titelbaum D S, Gansler T S. The fibrolamellar variant of hepatocellular carcinoma. Its association with focal nodular hyperplasia. Cancer . 1987; 60 3049-3055
8 Bralet M-P, Terris B, Vilgrain V. Epithelioid hemangioendothelioma, multiple focal nodular hyperplasias, and cavernous hemangiomas of the liver. An unusual association. Arch Pathol Lab Med . 1999; 123 846-849
9 Wanless I R. Epithelioid hemangioendothelioma, multiple focal nodular hyperplasias, and cavernous hemangiomas of the liver. Arch Pathol Lab Med . 2000; 124 1105-1107
10 Watanabe K, Saito A, Wakabayashi H. Two autopsy cases of primary leiomyosarcoma of the liver. Superiority of muscle-specific actin immunoreactivity in diagnosis. Acta Pathol Jpn . 1991; 41 461-465
11 Enzinger F M, Weiss S W. Soft Tissue Tumors, 3rd ed. St. Louis: CV Mosby, 1995: 511-522
12 Norton A J, Thomas J A, Isaacson P G. Cytokeratin-specific monoclonal antibodies are reactive with tumours of smooth muscle derivation. An immunocytochemical and biochemical study using antibodies to intermediate filament cytoskeletal proteins. Histopathology . 1987; 11 487-499
13 Butron Vila M M, Haot J, Desmet V J. Cholestatic features in focal nodular hyperplasia of the liver. Liver . 1984; 4 385-395
14 Wanless I R, Albrecht S, Bilbao J. Multiple focal nodular hyperplasia of the liver associated with vascular malformations of various organs and neoplasia of the brain: a new syndrome. Mod Pathol . 1989; 2 456-462
15 Goldin R D, Rose D S. Focal nodular hyperplasia of the liver associated with intracranial vascular malformations. Gut . 1990; 31 554-555
16 Mathieu D, Zafrani E S, Anglade M C. Association of focal nodular hyperplasia and hepatic hemangioma. Gastroenterology . 1989; 97 154-157
17 Saxena R, Humphreys S, Williams R. Nodular hyperplasia surrounding fibrolamellar carcinoma: a zone of arterialized liver parenchyma. Histopathology . 1994; 25 275-278