title: Liver biopsy for diagnosis of presumed benign hepatocellular lesions lacking magnetic resonance imaging diagnostic features of focal nodular hyperplasia.
abstract: The contribution of liver biopsy for the diagnosis of presumed benign hepatocellular lesions lacking the diagnostic features of focal nodular hyperplasia (FNH) on magnetic resonance imaging (MRI) is unknown. We evaluated liver biopsy and MRI performances in this setting.
  
  
  
  Magnetic resonance imaging and slides of liver biopsies performed for a presumed benign hepatocellular lesion (2006-2013) without the typical features of FNH on MRI were blindly reviewed (n = 45). Eighteen lesions were surgically removed and also analyzed. The final diagnosis was the diagnosis established after surgery or on the biopsy in the absence of surgery.
  
  
  
  The final diagnosis was FNH (n = 19), hepatocellular adenoma (HCA, n = 15), hepatocellular carcinoma (n = 3) and indefinite (n = 4). Four lesions corresponded to non hepatocellular lesions. FNH, HNF1A mutated and inflammatory HCA were diagnosed accurately on the biopsy in 95%, 67% and 100% of the cases respectively. Diagnostic performance of liver biopsy for HNF1A mutated HCA was lower because of the lack of non-tumoral tissue. Diagnosis based on morphological analysis was certain and correct in 27 cases. Immunostaining allowed a definite diagnosis in 12 additionnal cases. Radiological diagnosis was in agreement with the histological diagnosis in 75.6% of the cases, with a very high sensitivity (97%) and specificity (100%) for the diagnosis of HNF1A mutated HCA.
  
  
  
  Liver biopsy has a good diagnostic performance particularly for FNH and inflammatory HCA, and sampling of non-lesional tissue is highly recommended. A biopsy does not seem necessary if H-HCA is diagnosed on MRI.
authors.affiliation: AP-HP, Hôpital St Antoine, Paris, France. aureliesannier@free.fr.|Service d'Anatomie Pathologique, UPMC Univ Paris 06, Paris, France. aureliesannier@free.fr.
authors.forename: Aurélie
authors.initials: A
authors.lastname: Sannier
authors.affiliation: AP-HP, Hôpital St Antoine, Paris, France.|Service d'Imagerie, UPMC Univ Paris 06, Paris, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Cazejust
authors.affiliation: AP-HP, Hôpital St Antoine, Paris, France.|Service d'Hépatologie, UPMC Univ Paris 06, Paris, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Lequoy
authors.affiliation: AP-HP, Hôpital St Antoine, Paris, France.|Service d'Anatomie Pathologique, UPMC Univ Paris 06, Paris, France.|Sorbonne Universités, UPMC Univ Paris 06, Paris, France.
authors.forename: Pascale
authors.initials: P
authors.lastname: Cervera
authors.affiliation: AP-HP, Hôpital St Antoine, Paris, France.|Sorbonne Universités, UPMC Univ Paris 06, Paris, France.|Service de Chirurgie Hépato-biliaire, UPMC Univ Paris 06, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Scatton
authors.affiliation: AP-HP, Hôpital St Antoine, Paris, France.|Service d'Hépatologie, UPMC Univ Paris 06, Paris, France.|Sorbonne Universités, UPMC Univ Paris 06, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Rosmorduc
authors.affiliation: AP-HP, Hôpital St Antoine, Paris, France.|Service d'Anatomie Pathologique, UPMC Univ Paris 06, Paris, France.|Sorbonne Universités, UPMC Univ Paris 06, Paris, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Wendum
mesh_terms: D018248:Adenoma, Liver Cell / Q000175:diagnosis* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D020518:Focal Nodular Hyperplasia / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D005602:France; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology*; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: focal nodular hyperplasia; hepatocellular adenoma; liver biopsy; magnetic resonance imaging