Steatohepatitis-Like Changes in Hepatocellular Adenoma

Area of Science:

• Hepatology
• Pathology
• Gastroenterology

Background:

• Hepatocellular adenoma (HCA) is a benign liver tumor.
• Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are increasingly prevalent liver conditions.
• The steatohepatitic morphology in HCA and its association with NAFLD/NASH risk factors require further investigation.

Purpose of the Study:

• To determine the frequency of steatohepatitic morphology in hepatocellular adenoma (HCA).
• To correlate steatohepatitic changes in HCA with clinical parameters and risk factors of nonalcoholic fatty liver disease (NAFLD) or nonalcoholic steatohepatitis (NASH).

Main Methods:

• Analysis of 41 liver resection specimens diagnosed with HCA for steatohepatitic changes.
• Evaluation of background nonneoplastic liver.
• Review of clinical records for NAFLD/NASH risk factors.

Main Results:

• Six steatohepatitic HCAs (SH-HCAs) were identified, representing 14.6% of cases.
• SH-HCAs were associated with HNF1α inactivation or inflammatory subtypes, but not β-catenin mutations.
• Patients with SH-HCA frequently had NAFLD/NASH risk factors including obesity, diabetes, and hypertension.

Conclusions:

• Around 15% of HCAs exhibited steatohepatitic changes.
• The absence of steatohepatitic morphology in the β-catenin mutated subtype of HCA provides reassurance for this variant.