Table 1.
Clinicopathologic characteristics of different hepatocellular adenoma subtypes
HCA subtype | Risk factors | Specific clinical features | Histologic features | IHCs |
HHCA | HNF1A germline mutations, MODY type 3, microsatellite instability | Hepatic adenomatosis | Intralesional steatosis | LFABP (absent/decreased) |
IHCA | Obesity, alcohol, glycogenosis | Inflammatory syndrome | Sinusoidal dilatation, inflammatory infiltrate | CRP, SAA |
bex3HCA | Male, liver vascular disease, androgen therapy | Frequent malignant transformation | Pseudoacinar formation, mild nuclear atypia | beta-catenin (nuclear staining), GS (diffuse and strong) |
bex7,8HCA | No specific risk factors | No specific clinical features | No specific features | GS (weak, heterogeneous) |
shHCA | Obesity | Symptomatic bleeding | Intratumoural hemorrhage | Prostaglandin D2 synthase |
UHCA | No specific risk factors | No specific clinical features | No specific features | None |
HCA: Hepatocellular adenoma; IHCs: Immunohistochemical stains; HNF1A: hepatocyte nuclear factor 1 homeobox alpha; HHCA: HNF1A-inactivated hepatocellular adenoma; IHCA: Inflammatory hepatocellular adenoma; bex3HCA: Beta-catenin-mutated hepatocellular adenoma (exon 3); bex7,8HCA: Beta-catenin-mutated hepatocellular adenoma (exon 7/8); shHCA: Sonic hedgehog-activated hepatocellular adenoma; UHCA: Unclassified hepatocellular adenoma; MODY: Maturity-onset diabetes of the young; LFABP: Liver fatty acid binding protein; CRP: C-reactive protein; SAA: Serum amyloid A; GS: Glutamine synthetase.