Table 2.
Phenotypic classification of hepatocellular adenoma: routine histology and immunohistochemistry (IHC) and molecular biology.
| Routine histology | In favor of | IHC |
|---|---|---|
| (i) Diffuse steatosis (ii) Lobulated contour (surgical specimen) (iii) No criteria for IHCA |
H-HCA | Lack of LFABP → H-HCA |
| (iv) Inflammation (v) Sinusoidal dilatation (vi) Pseudoportal tracts (with thick arteries) (vii) Ductular reaction |
IHCA* | CRP/or SAA + → IHCA CRP/or SAA +/GS**+ → b-IHCA |
| GS** + (CRP−) → b-HCA | ||
| All markers− → UHCA |
In the absence of typical routine histological criteria for H-HCA or IHCA, the other HCA subtypes are likely *include b-IHCA (GS is mandatory to differentiate IHCA and b-IHCA).
**Perform in addition β-catenin staining: aberrant nuclear staining confirm the diagnosis; its absence does not rule out; however, the diagnosis, particularly on needle biopsies, needs molecular biology for definite diagnosis.