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Hepatocellular nodules in vascular liver diseases

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Abstract

Hepatocellular nodules have been recognized in vascular liver diseases for a long time and mostly described and studied in the imaging literature. Some confusions in their identification and overlap in their definitions exist, especially in this specific clinical context. Pathology descriptions report the development of nodular regenerative hyperplasia, large regenerative nodule, and focal nodular hyperplasia, as adaptive responses of the liver parenchyma to the modified blood flow. True neoplastic hepatocellular nodules such as hepatocellular adenoma and hepatocellular carcinoma can also appear, mainly in Budd-Chiari syndrome, and have to be correctly diagnosed. This is more difficult for the radiologist in these diseased livers, leading more frequently to perform liver biopsies. We describe the histology of each type of well-differentiated hepatocellular nodules and provide some clues for their differential diagnosis. A review of the literature gives an historical perspective of the problem and enlightens the frequency and the subtypes of hepatocellular nodules found in the most common vascular liver diseases.

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Acknowledgements

This review is dedicated to Reginald Brenard, hepatologist, who was the first to draw the attention of Christine Sempoux on the importance of the development of liver nodules in vascular liver diseases, and who creates a registry in Belgium for patients with Hereditary Hemorrhagic Telangiectasia to improve their clinical management [84].

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Authors and Affiliations

  1. Service of Clinical Pathology, Lausanne University Hospital, Institute of Pathology, 25, rue du Bugnon, 1011, Lausanne, Switzerland

    Christine Sempoux

  2. Inserm, UMR1053 Bordeaux Research In Translational Oncology, BaRITOn, F-33000 Bordeaux, Université de Bordeaux, 33076, Bordeaux, France

    Charles Balabaud & Paulette Bioulac-Sage

  3. Pathology department, Beaujon hospital, Inserm UMR 1149, Université Paris Diderot, 101 bd du Général Leclerc, 92110, Clichy, France

    Valérie Paradis

Authors
  1. Christine Sempoux
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  2. Charles Balabaud
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  3. Valérie Paradis
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  4. Paulette Bioulac-Sage
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Correspondence to Christine Sempoux.

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This article is part of the Topical Collection on Vascular liver lesions: contemporary views on long-recognized entities

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Sempoux, C., Balabaud, C., Paradis, V. et al. Hepatocellular nodules in vascular liver diseases. Virchows Arch 473, 33–44 (2018). https://doi.org/10.1007/s00428-018-2373-6

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