1884
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HNF1a inactivated hepatocellular adenoma.
Liver
Haematoxylin & Eosin (H&E)
25 years
female
25 year old female with obesity. Two liver nodules upon radiological examination.
In this resection specimen one can appreciate a sharply yet not encapsulated tumor composed of inconspicuous looking hepatocytes. Mitoses and atypia are absent. However, there are prominent intratumoral arteries that are not accompanied by biliary ductules (so-called ‘unpaired arteries’). The surrounding liver parenchyma shows marked steatosis without significant fibrosis or cirrhosis. Of note, there is no steatosis within the hepatocellular adenoma.
Immunohistochemically, there is loss of LFABP expression within the hepatocellular adenoma. Expression of beta-catenin and glutamine synthetase is normal while SAA staining is negative. This immunophenotype is compatible with a HNF1a-inactivated hepatocellular adenoma, although absence of steatosis within the tumor is rather unusual.
Based on their molecular and immunohistochemical profiles, hepatocellular adenoma can be classified into the following four subtypes: HNF1a inactivated (HA-H), inflammatory (HA-I), beta-catenin mutated (HA-B) and unclassified (HA-U).
Philippe Brunner, University of Basel
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