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Il Giornale Italiano di Radiologia Medica 2018 Novembre-Dicembre;5(6):809-15

DOI: 10.23736/S2283-8376.18.00136-5

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: Italian

Magnetic resonance imaging in characterization of hepatocellular adenomas: correlation with the new histopathological-molecular classification

Maria G. MARINI 1 , Anna M. DE GAETANO 1, Marialavinia CATALANO 1, Maria VELLONE 2, Maurizio POMPILI 3, Fabio M. VECCHIO 4, Riccardo MANFREDI 1, HepatoCATT Study Group 

1 Unità di Radiologia, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica e Ematologia, Fondazione Policlinico Universitario A. Gemelli, IRCCS-Università Cattolica del Sacro Cuore, Roma, Italia; 2 Unità di Chirurgia Generale ed Epato-Biliare, Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS-Università Cattolica del Sacro Cuore, Roma, Italia; 3 Unità di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS-Università Cattolica del Sacro Cuore, Roma, Italia; 4 Unità di Anatomia Patologica Macroscopica, Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS-Università Cattolica del Sacro Cuore, Roma, Italia


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Hepatocellular adenoma (HCA) is a rare hepatic benign neoplasm that occurs more frequently in young women (male-to-female ratio 1:10). The main risk factor is represented by the use of oral contraceptives for long-term and others are use of anabolic steroids, glycogen storage disorders, obesity and metabolic syndrome. Almost 50% of HCAs are diagnosed incidentally in asymptomatic patients and the two main complications are hemorrhage and malignant transformation into hepatocellular carcinoma. A recent new classification system, introduced by the Bordeaux group and based on genetic and histopathological characteristics, classifies HCAs into four subtypes: 1) hepatocyte nuclear factor 1 alpha (HNF1α) inactivated HCA; 2) inflammatory HCA; 3) β catenin-mutated HCA; 4) unclassified HCAs. Each subtype shows a different biological evolution and magnetic resonance (MR) is the technique of choice in identification and characterization of each HCA subtype, leading to an appropriate management of these patients. In particular, MR has an elevated diagnostic accuracy for two HCA types: the HNF1α inactivated HCA and the inflammatory one. The aim of our work is to describe MR appearance of hepatocellular adenomas, focusing on each genetic and histopathological subtype characterization.


KEY WORDS: Adenoma, liver cell - Magnetic resonance imaging - Molecular biology - Immunohistochemistry

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