Multiple inflammatory and serum amyloid A positive telangiectatic hepatic adenomas with glycogenated nuclei arising in a background of nonalcoholic steatohepatitis

Semin Liver Dis. 2008 Nov;28(4):434-9. doi: 10.1055/s-0028-1091987. Epub 2008 Oct 27.

Abstract

The authors describe multiple telangiectatic or inflammatory adenomas in a 53-year-old woman with steatohepatitis who presented with acute right upper quadrant abdominal pain. Magnetic resonance imaging revealed 6 lesions consistent with multiple hepatic adenomas, 2 of which showed hemorrhage. She underwent right lobectomy and nonanatomical segment 2 liver resections and seven nodules ranging in size from 1.0 to 5.0 cm were identified. All nodules contained portal-like structures and ductular reaction, features seen in focal nodular hyperplasia, as well as significant inflammation, telangiectatic sinusoids and immunoreactivity for serum amyloid A, placing them according to a recently described classification systems as telangiectatic or inflammatory adenomas. The diffuse positivity of the serum amyloid A staining results in this case suggests an important diagnostic role of this stain in smaller tissue samples, such as in core biopsy specimens.

Publication types

  • Case Reports

MeSH terms

  • Adenoma / epidemiology
  • Adenoma / pathology*
  • Comorbidity
  • Fatty Liver / epidemiology
  • Fatty Liver / pathology*
  • Female
  • Humans
  • Immunohistochemistry
  • Liver / pathology
  • Liver Neoplasms / epidemiology
  • Liver Neoplasms / pathology*
  • Magnetic Resonance Imaging
  • Middle Aged
  • Serum Amyloid A Protein / analysis*
  • Telangiectasis / pathology

Substances

  • Serum Amyloid A Protein