ArticleModern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc2015
Pigmented hepatocellular adenomas have a high risk of atypia and malignancy.
Article in Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9 citing papers in PubMed, 38 citations in OpenAlex.
- Integration of histopathology and molecular features for the classification of benign and malignant hepatocellular neoplasms.Virchows Archiv : an international journal of pathology · 2026Review
- β-Catenin-activated inflammatory hepatocellular adenoma with pigmentation and atypical features: a case report.Clinical journal of gastroenterology · 2023Article
- Hepatocellular adenoma: Where are we now?World journal of gastroenterology · 2022Article
- Hepatocellular adenomas: recent updates.Journal of pathology and translational medicine · 2021Review
- Hepatocellular Adenoma and Focal Nodular Hyperplasia.Clinical liver disease · 2021Review
- Biopsies of hepatocellular carcinoma with no reticulin loss: an important diagnostic pitfall.Human pathology · 2021Article
- Unclassified hepatocellular adenoma with histological brown pigment deposition and serum PIVKA-II level elevation: a case report.Surgical case reports · 2020Article
- Malignant transformation of liver fatty acid binding protein-deficient hepatocellular adenomas: histopathologic spectrum of a rare phenomenon.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2020Article
- Giant hepatocellular carcinoma with bone metastasis in a young adult, emerged from pigmented adenoma with beta-Catenin activation: A case report.International journal of surgery case reports · 2017Article
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4 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
Pigment deposition is occasionally seen in hepatocellular adenomas. Several reports suggest that pigmented hepatocellular adenomas have increased risk of malignancy, but these tumors remain incompletely understood. To determine the frequency of pigment deposition, we evaluated and classified 109 well-differentiated hepatocellular neoplasms that were originally diagnosed or submitted in consultation as hepatocellular adenomas and found 27 (25%) pigmented tumors. All were negative on iron stain and in three cases electron microscopy confirmed the pigment was lipofuscin. The lipofuscin intensely stained with glypican-3 in most cases (89%). Of the 27 pigmented tumors, 11 cases (41%) were classified as hepatocellular adenomas, 7 cases (27%) were classified as atypical hepatocellular adenomas/hepatocellular neoplasms of uncertain malignant potential, and 9 cases (33%) were reclassified as well-differentiated hepatocellular carcinomas. Four (of 9) hepatocellular carcinomas arose in pigmented hepatocellular adenomas, giving a rate of malignant transformation in pigmented hepatocellular adenomas of 27%. Of the total 27 pigmented tumors, 78% were in women and 22% in men, but interestingly only men had tumors classified as hepatocellular carcinoma or hepatocellular neoplasm of uncertain malignant potential. Also of note, a total of 10 individuals (37%) had multiple hepatocellular neoplasms but in 9 of these cases the other adenomas were non-pigmented. Importantly, in cases with multiple hepatocellular neoplasms, only the pigmented hepatocellular neoplasms had atypia or malignancy. Genotype-phenotype classification of the pigmented tumors showed different subtypes: HNF1α inactivated (48%), β-catenin activated (26%), inflammatory (15%), concurrently β-catenin activated and inflammatory in 1 hepatocellular adenoma, concurrently HNF-1α inactivated and β-catenin activated in 1 hepatocellular adenoma, and unclassified in 1 hepatocellular carcinoma. In conclusion, hepatocellular adenomas with lipofuscin pigment are a heterogeneous group of adenomas, with HNF-1α inactivation being the commonest genotype. They have an increased risk of atypia and malignancy, especially in males.
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