The identification of small nodules in liver adenomatosis

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The identification of small nodules in liver adenomatosis Sébastien Lepreux, Christophe Laurent, Jean Frédéric Blanc, Hervé Trillaud, Brigitte Le Bail, Hélène Trouette, Jean Saric, Jessica Zucman-Rossi, Charles Balabaud, Paulette Bioulac-Sage Journal of Hepatology Volume 39, Issue 1, Pages 77-85 (July 2003) DOI: 10.1016/S0168-8278(03)00145-4

Fig. 1 Fusion of two nodules separated by a fibrous band containing portal tracts (not visible at this magnification). H&E (case 7). Journal of Hepatology 2003 39, 77-85DOI: (10.1016/S0168-8278(03)00145-4)

Fig. 2 Lobulation appears distinctly inside this 1.5 cm non-typical nodule. In between steatotic areas, rows of non-steatotic hepatocytes are seen with portal tract-like structures ((a) CD34) containing occasional biliary cells (arrow) ((b) cyto K7). In another part of the same nodule, a 1 mm steatotic area with portal tracts at its periphery (arrow) fuses to the main nodule ((c) cytoK7) (case 6). Journal of Hepatology 2003 39, 77-85DOI: (10.1016/S0168-8278(03)00145-4)

Fig. 3 A 250 μm steatotic focus with some degree of architectural disorganization. H&E (case 6). Journal of Hepatology 2003 39, 77-85DOI: (10.1016/S0168-8278(03)00145-4)

Fig. 4 A 650 μm micronodule formed of several steatotic foci compressing the surrounding parenchyma. On the right, another non-steatotic focus tends to fuse to the micronodule. A portal tract containing a bile duct (not visible at this magnification) is seen in between. H&E (case 2). Journal of Hepatology 2003 39, 77-85DOI: (10.1016/S0168-8278(03)00145-4)

Fig. 5 A 900 μm micronodule formed of several steatotic foci has irregular contours on the left side and contains portal tracts (arrow) ((a) H&E). In some portal tracts, portal vein, arteries, bile duct (arrow) are visible ((b) H&E) (case 3). Journal of Hepatology 2003 39, 77-85DOI: (10.1016/S0168-8278(03)00145-4)

Fig. 6 This large adenoma seems to be composed of several micronodules at its periphery (left part). A micronodule is seen close to the border (lower right). H&E (case 7). Journal of Hepatology 2003 39, 77-85DOI: (10.1016/S0168-8278(03)00145-4)

Fig. 7 This 5 mm steatotic nodule is lobulated. The distribution of cytokeratin 7 positive cells is not different inside and outside (lower part of the photograph) the nodule (a). At a higher magnification, there are portal tracts. In an area containing extracellular matrix, mixed with some inflammatory cells, there are many arteries, vessels and biliary cells (arrow). This nodule is interpreted as an FNH precursor. H&E (case 6). Journal of Hepatology 2003 39, 77-85DOI: (10.1016/S0168-8278(03)00145-4)

Fig. 8 Diagram of the different types of lesions seen in adenomatosis (to the exception of focal nodular hyperplasia and their precursor lesion). Journal of Hepatology 2003 39, 77-85DOI: (10.1016/S0168-8278(03)00145-4)