title: Severe cytological atypia (large cell change) in focal nodular hyperplasia with numerous mallory bodies. A benign (adaptive) change?
abstract: Focal nodular hyperplasia (FNH) is a benign hepatocellular lesion composed of hyperplastic appearing hepatocytes arranged in nodules separated by fibrous septa that usually form a central stellate scar. Rare lesions that show unusual cytological or architectural features were reported as variants of focal nodular hyperplasia. We present the morphological features of a case of FNH with severe cytological atypia (so-called large cell change) in a 73-year-old man. In addition to diffuse cytological atypia, Mallory hyaline bodies were found in almost all lesional cells. This rare variant of FNH should be differentiated from other neoplastic lesions, in particular from the fibrolamellar variant of hepatocellular carcinoma.
authors.affiliation: Institute of Pathology, Clinical Center of Nuremberg, Germany.
authors.forename: Abbas
authors.initials: A
authors.lastname: Agaimy
authors.forename: Annette
authors.initials: A
authors.lastname: Kaiser
authors.forename: Peter H
authors.initials: PH
authors.lastname: Wuensch
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis; D003937:Diagnosis, Differential; D020518:Focal Nodular Hyperplasia / Q000378:metabolism / Q000473:pathology*; D022781:Hepatocytes / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D002479:Inclusion Bodies / Q000378:metabolism / Q000473:pathology*; D008099:Liver / Q000473:pathology*; D008113:Liver Neoplasms / Q000175:diagnosis; D008297:Male; D011506:Proteins / Q000378:metabolism; D025801:Ubiquitin / Q000378:metabolism
chemical_list: C027596:Mallory body protein, human; D011506:Proteins; D025801:Ubiquitin