title: Telangiectatic hyperplastic nodule associated with vascular malformation in a patient with chronic hepatitis B: radiologic and pathologic features.
abstract: Recognizing hepatocellular nodules that cannot be classified as typical for hepatocellular carcinoma, hepatocellular adenoma, or focal nodular hyperplasia is important, especially in a patient with high risk for hepatocellular carcinoma. The authors report a case of a 53-year-old man with chronic hepatitis B, who was referred to the hospital with a liver mass found on routine imaging follow-up. Abdominal ultrasound revealed a 2.4-cm hypoechoic lesion. Contrast computed tomography showed homogeneous arterial enhancement and mild hyperdensity on portal venous phase images. Due to the high risk for hepatocellular carcinoma, the patient underwent laparoscopic left lateral segmentectomy that revealed a 2.2-cm poorly defined red-brown lesion. The nodule was diagnosed as a hypervascular/telangiectatic hyperplastic hepatocellular nodule based on histopathologic findings and immunostaining profile with negative glutamine synthetase, diffuse positive CD34 highlighting hyperplastic endothelial cells along the telangiectatic sinusoids and dilated vascular channels, and CK7 and CK19 reactive normal bile ducts within the lesion.
authors.affiliation: Division of Liver Pathology, Department of Pathology, The Lillian and Henry Stratton - Hans Popper, Icahn School of Medicine at Mount Sinai, New York, New York 10029, USA. gonzalo.carrascoavino@mountsinai.org
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Carrasco
authors.forename: Cecilia
authors.initials: C
authors.lastname: Besa
authors.forename: Sara C
authors.initials: SC
authors.lastname: Lewis
authors.forename: Hena S
authors.initials: HS
authors.lastname: Kadri
authors.forename: Spiros
authors.initials: S
authors.lastname: Hiotis
authors.forename: Swan N
authors.initials: SN
authors.lastname: Thung
mesh_terms: D015415:Biomarkers / Q000032:analysis; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000821:virology; D003937:Diagnosis, Differential; D020518:Focal Nodular Hyperplasia / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery; D006498:Hepatectomy; D019694:Hepatitis B, Chronic / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000175:diagnosis / Q000821:virology; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011237:Predictive Value of Tests; D013684:Telangiectasis / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery; D018615:Ultrasonography, Doppler, Color; D054079:Vascular Malformations / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery
chemical_list: D015415:Biomarkers