title: Focal nodular hyperplasia of the liver: an emerging complication of hematopoietic SCT in children.
abstract: Hepatic focal nodular hyperplasia (FNH) is a nonmalignant condition rarely affecting children previously treated for cancer, especially those who received hematopoietic SCT (HSCT). Some aspects of its pathogenesis still remain unclear and a strong association with specific risk factors has not yet been identified. We report here a single institution's case series of 17 patients who underwent HSCT and were diagnosed with FNH, analyzing retrospectively their clinical features and the radiological appearance of their hepatic lesions. We aimed to compare the diagnostic accuracy of ultrasound (US) and magnetic resonance imaging (MRI) and to explore the role of transient elastography (FibroScan) to evaluate the degree of hepatic fibrosis in FNH patients. Our analysis showed an association of FNH with age at transplant ⩽12 years (hazard ratio (HR) 9.10); chronic GVHD (HR 2.99); hormone-replacement therapy (HR 4.02) and abdominal radiotherapy (HR 4.37). MRI proved to be a more accurate diagnostic tool compared with US. Nine out of 12 patients who underwent FibroScan showed hepatic fibrosis. Our study points out that FNH is an emerging complication of HSCT, which requires a lifelong surveillance to follow its course in cancer patients.
authors.affiliation: Clinic of Pediatric Hemato-Oncology, Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Pillon
authors.affiliation: Clinic of Pediatric Hemato-Oncology, Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy.
authors.forename: N S
authors.initials: NS
authors.lastname: Carucci
authors.affiliation: Clinic of Pediatric Hemato-Oncology, Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Mainardi
authors.affiliation: Clinic of Pediatric Hemato-Oncology, Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Carraro
authors.affiliation: Department of Radiology, University Hospital of Padova, Padova, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Zuliani
authors.affiliation: Medicine Department-DIMED, University Hospital of Padova, Padova, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Chemello
authors.affiliation: Clinic of Pediatric Hemato-Oncology, Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Calore
authors.affiliation: Clinic of Pediatric Hemato-Oncology, Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Tumino
authors.affiliation: Clinic of Pediatric Hemato-Oncology, Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Varotto
authors.affiliation: Department of Radiology, University Hospital of Padova, Padova, Italy.
authors.forename: T
authors.initials: T
authors.lastname: Toffolutti
authors.affiliation: Clinic of Pediatric Hemato-Oncology, Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Destro
authors.affiliation: Clinic of Pediatric Hemato-Oncology, Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy.
authors.forename: M V
authors.initials: MV
authors.lastname: Gazzola
authors.affiliation: Pathology University of Padova, Padova, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Alaggio
authors.affiliation: Clinic of Pediatric Hemato-Oncology, Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Basso
authors.affiliation: Clinic of Pediatric Hemato-Oncology, Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Messina
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D020518:Focal Nodular Hyperplasia / Q000209:etiology* / Q000473:pathology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods