title: Focal nodular hyperplasia-like nodule with reduced expression of organic anion transporter 1B3 in alcoholic liver cirrhosis.
abstract: We report a patient with alcoholic liver cirrhosis who had a 15 mm focal nodular hyperplasia (FNH)-like nodule in the liver. This FNH-like nodule was diagnosed as hepatocellular carcinoma (HCC) mainly based on hypervascularity during the hepatic arterial phase, washout pattern during the equilibrium phase and low signal intensity during the hepatobiliary phase in gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI; it was surgically resected. Its histology exhibited hepatocyte hyperplasia, fibrous septa containing unpaired small arteries accompanied by reactive bile ductules, remarkable iron deposits and sinusoidal capillarization, and was compatible with the diagnosis of an FNH-like nodule. When we analyzed the images of the present nodule retrospectively, low signal intensity on in-phase and isosignal intensity on opposed-phase T1-weighted MRI may have reflected iron deposits in the FNH-like nodule. In addition, a low signal intensity on T2-weighted MRI and no detection in diffusion-weighted MRI may help in distinguishing FNH-like nodules from HCC, since these image findings are inconsistent with typical HCC. Immunohistochemical analysis revealed a markedly reduced expression of organic anion transporter (OATP) 1B3 in this nodule, which implied decreased Gd-EOB-DTPA uptake by hepatocytes and accounted for the low signal intensity during the hepatobiliary phase on Gd-EOB-DTPA-enhanced MRI. To the best of our knowledge this is the first report in which an FNH-like nodule was assessed for OATP1B3 expression.
authors.affiliation: Department of Hepatology and Pancreatology, Kawasaki Medical University, Japan.
authors.forename: Nobuko
authors.initials: N
authors.lastname: Doi
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Tomiyama
authors.forename: Tomoya
authors.initials: T
authors.lastname: Kawase
authors.forename: Sohji
authors.initials: S
authors.lastname: Nishina
authors.forename: Naoko
authors.initials: N
authors.lastname: Yoshioka
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Hara
authors.forename: Koji
authors.initials: K
authors.lastname: Yoshida
authors.forename: Keiko
authors.initials: K
authors.lastname: Korenaga
authors.forename: Masaaki
authors.initials: M
authors.lastname: Korenaga
authors.forename: Takuya
authors.initials: T
authors.lastname: Moriya
authors.forename: Atsushi
authors.initials: A
authors.lastname: Urakami
authors.forename: Osamu
authors.initials: O
authors.lastname: Nakashima
authors.forename: Masamichi
authors.initials: M
authors.lastname: Kojiro
authors.forename: Keisuke
authors.initials: K
authors.lastname: Hino
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology; D003937:Diagnosis, Differential; D020518:Focal Nodular Hyperplasia / Q000209:etiology / Q000378:metabolism* / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000473:pathology / Q000601:surgery; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications*; D008113:Liver Neoplasms / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D029362:Organic Anion Transporters, Sodium-Independent / Q000378:metabolism*; D000074542:Solute Carrier Organic Anion Transporter Family Member 1B3; D016896:Treatment Outcome
chemical_list: D029362:Organic Anion Transporters, Sodium-Independent; C421209:SLCO1B3 protein, human; D000074542:Solute Carrier Organic Anion Transporter Family Member 1B3