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Hepatocellular carcinoma and nodular regenerative hyperplasia: possible pathogenetic relationship
U C Nzeako1, Z D Goodman, K G Ishak
1Division of Hepatic Pathology, Armed Forces Institute of Pathology, Washington D.C., USA.
The American Journal of Gastroenterology
|May 1, 1996
Summary
Nodular regenerative hyperplasia (NRH) may precede hepatocellular carcinoma (HCC) in noncirrhotic livers, particularly when liver cell dysplasia is present. The exact temporal relationship between NRH and HCC requires further investigation.
Area of Science:
- Hepatology
- Oncology
- Pathology
Background:
- Hepatocellular carcinoma (HCC) can arise in noncirrhotic livers.
- Nodular regenerative hyperplasia (NRH) is a non-neoplastic liver condition associated with liver cell dysplasia, a potential precursor to HCC.
Purpose of the Study:
- To investigate if NRH is a precursor to HCC in noncirrhotic livers.
- To examine the role of portal vein obstruction in NRH associated with HCC.
Main Methods:
- Retrospective review of histological slides and clinical records of 804 patients.
- Selection of cases with associated HCC and NRH.
- Statistical comparison of variables between groups with and without NRH.
Main Results:
- Of 342 noncirrhotic patients, 23 had NRH.
- Seventy-three percent of NRH cases exhibited liver cell dysplasia.
- Liver cell dysplasia was significantly more common in patients with NRH (p < 0.01).
Conclusions:
- HCC may develop within dysplastic foci in NRH livers.
- NRH might also develop secondary to HCC with portal vein invasion.
- The temporal relationship between HCC and NRH is multifactorial.