Telangiectatic adenoma: an entity associated with increased body mass index and inflammation.
What were previously called telangiectatic focal nodular hyperplasias are in fact true adenomas with telangiectatic features (TAs) without overt characterized genetic abnormalities. The aim of our study was to review a surgical series of TAs in order to describe clinical, biological, and radiological findings of these lesions and to evaluate their outcomes. From January 1996 to November 2005, 284 patients with benign hepatocellular nodules underwent surgical resection at Beaujon Hospital. Among them, 32 TAs from 27 patients were diagnosed. Ninety-two percent of the patients were women. Mean age was 38 years (range 17-63). Mean body mass index was 28 (range 18-49), with 16 patients being overweight. Symptoms revealed lesions in 10 patients. In 13 patients, TA was associated with another benign liver lesion. Mean size of the TAs was 5 cm (range 1-17 cm). Histological analysis showed cellular atypias in 6 cases (19%), steatosis in 17 cases (53%), vascular changes in 19 cases (59%), and significant inflammatory infiltrate in 29 cases (91%). In 1 case, the TA had foci of well-differentiated hepatocellular carcinoma. In 18 of the 26 cases (69%), adjacent liver showed significant steatosis. Serum biomarkers of inflammation were increased in 90% of patients (19 of 22). After surgical resection, inflammatory marker levels returned to normal values in all patients tested.


CONCLUSIONS
This study has shown that TAs occur in a characteristic background of overweight patients and are often associated with a biological inflammatory syndrome. Moreover, a TA may progress to malignancy.
Paradis
Valérie
V
Service d'Anatomie pathologique, Hôpital Beaujon, Clichy, France. vparadis@teaser.fr
Champault
Axelle
A
Ronot
Maxime
M
Deschamps
Lydia
L
Valla
Dominique-Charles
DC
Vidaud
Dominique
D
Vilgrain
Valérie
V
Belghiti
Jacques
J
Bedossa
Pierre
P
D000236:Adenoma / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D006801:Humans; D007249:Inflammation / Q000503:physiopathology*; D008113:Liver Neoplasms / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013684:Telangiectasis / Q000209:etiology* / Q000473:pathology; D015430:Weight Gain / Q000502:physiology*