Nodular hyperplasia surrounding fibrolamellar carcinoma: a zone of arterialized liver parenchyma

R. SAXENA, S. HUMPHREYS, R. WILLIAMS, B. PORTMANN

Research output: Contribution to journalArticle

39 Scopus citations

Abstract

We report a case of acetaminophen‐induced liver necrosis in a 14‐year‐old girl. At autopsy, a 9 cm subcapsular nodule was present in the right lobe of the liver which showed distinct zonation: a central greyish white area of fibrolamellar carcinoma with a peripheral fleshy, tan‐coloured rim ranging from 1 to 2 cm in thickness. This peripheral zone consisted of nodular, hyperplastic parenchyma resembling the changes seen in focal nodular hyperplasia, and stood out from the adjacent necrotic parenchyma. The sparing of this zone from the deleterious effects of acetaminophen provides indirect evidence of a predominantly arterial rather than portal blood supply to this region. The arterial supply was most probably derived from the tumour vasculature and may explain the parenchymal hyperplasia sometimes reported adjacent to a fibrolamellar carcinoma. Awareness of this phenomenon is essential when evaluating a needle biopsy, as sampling of this region may lead to a false negative diagnosis.

Original languageEnglish (US)
Pages (from-to)275-278
Number of pages4
JournalHistopathology
Volume25
Issue number3
DOIs
StatePublished - Sep 1994
Externally publishedYes

Keywords

  • Keywords: liver tumour, focal nodular hyperplasia, fibrolamellar carcinoma, acetaminophen toxicity, fulminant liver failure

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

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