Asami Izu1,2, Masahiko Sugitani1,3, Noriko Kinukawa1,3, Hiroshi Matsumura4, Masahiro Ogawa4, Mitsuhiko Moriyama4, Shintaro Yamazaki5, Tadatoshi Takayama5, Hiroshi Hano6, Takashi Yao7, Hiroaki Kanda8,9, Koyu Suzuki10, Seisyu Hayashi11, Syunichi Ariizumi12, Masakazu Yamamoto12, Yukio Morishita13, Koshi Matsumoto14, Naoya Nakamura15, Masayuki Nakano16. 1. Department of Pathology, Nihon University School of Medicine, Tokyo, Japan. 2. Department of Diagnostic Pathology, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan. 3. Department of Diagnostic Pathology, Ageo Central General Hospital, Ageo, Saitama, Japan. 4. Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan. 5. Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan. 6. Department of Pathology, Jikei University School of Medicine, Tokyo, Japan. 7. Department of Human Pathology, Juntendo University Graduate School of Medicine, Tokyo, Japan. 8. Department of Pathology, The Cancer Institute of Japanese Foundation for Cancer Research, Tokyo, Japan. 9. Department of Pathology, Saitama Cancer Center, Ina, Saitama, Japan. 10. Department of Pathology, Saint Luke's International Hospital, Tokyo, Japan. 11. Department of Internal Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan. 12. Department of Gastroenterological Surgery, Tokyo Women's Medical University, Tokyo, Japan. 13. Diagnostic Pathology Division, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan. 14. Pathology Division, Ebina General Hospital, Ebina, Kanagawa, Japan. 15. Department of Pathology, Tokai University School of Medicine, Isehara, Kanagawa, Japan. 16. Tokyo Central Pathology Laboratory, Tokyo, Japan.
Abstract
AIM: Hepatocellular adenoma (HCA) has a lower prevalence in Japan than in Western countries and HCA subtypes have been reported for only a few Japanese patients. We analyzed HCA subtype data 38 patients from 23 hospitals in Japan in order to examine character and difference between Western countries. METHODS: To confirm HCA and to analyze subtypes, we performed immunohistochemical examinations. RESULTS: Thirty-eight cases were found to have HCA without cirrhosis. The male/female ratio was 18/20. Ages ranged from 15 to 79 (average, 43.2) years. Male and elder patients are not rare, furthermore, most of elder patients are male. Glycogen storage disease, past history of medicament use, hepatitis B virus surface antigen-positivity, antihepatitis C virus -positivity, diabetes mellitus, obesity, lipid metabolism disorder and alcoholism were present in of 6, 8, 1, 1, 6, 6, 4, and 6 cases, respectively. As to HCA subtypes, HNF1alpha-inactivated HCA, beta-catenin activated HCA (b-HCA), inflammatory HCA (IHCA) and unclassified HCA (U-HCA) accounted for nine (23.7%), four (10.5%), 17 (44.7%) and eight (21.1%) cases, respectively. Two cases showed coexistence of HCA and hepatocellular carcinoma (HCC) at surgery, and another had HCC which had been detected 23 years after HCA diagnosis. The HCA subtype of one of the former cases was U-HCA, while the remaining two had b-HCA and U-HCA. CONCLUSIONS: In Japanese HCA cases, the proportions of U-HCA, male and elder cases were slightly higher than in Western countries, and most of elder patients were male. IHCA was however common regardless of race, and was assumed to be the predominant subtype of HCA.
AIM: Hepatocellular adenoma (HCA) has a lower prevalence in Japan than in Western countries and HCA subtypes have been reported for only a few Japanese patients. We analyzed HCA subtype data 38 patients from 23 hospitals in Japan in order to examine character and difference between Western countries. METHODS: To confirm HCA and to analyze subtypes, we performed immunohistochemical examinations. RESULTS: Thirty-eight cases were found to have HCA without cirrhosis. The male/female ratio was 18/20. Ages ranged from 15 to 79 (average, 43.2) years. Male and elder patients are not rare, furthermore, most of elder patients are male. Glycogen storage disease, past history of medicament use, hepatitis B virus surface antigen-positivity, antihepatitis C virus -positivity, diabetes mellitus, obesity, lipid metabolism disorder and alcoholism were present in of 6, 8, 1, 1, 6, 6, 4, and 6 cases, respectively. As to HCA subtypes, HNF1alpha-inactivated HCA, beta-catenin activated HCA (b-HCA), inflammatory HCA (IHCA) and unclassified HCA (U-HCA) accounted for nine (23.7%), four (10.5%), 17 (44.7%) and eight (21.1%) cases, respectively. Two cases showed coexistence of HCA and hepatocellular carcinoma (HCC) at surgery, and another had HCC which had been detected 23 years after HCA diagnosis. The HCA subtype of one of the former cases was U-HCA, while the remaining two had b-HCA and U-HCA. CONCLUSIONS: In Japanese HCA cases, the proportions of U-HCA, male and elder cases were slightly higher than in Western countries, and most of elder patients were male. IHCA was however common regardless of race, and was assumed to be the predominant subtype of HCA.