Download PDF
Z Gastroenterol 2003; 41(2): 191-200
DOI: 10.1055/s-2003-37316
Übersicht
© Karl Demeter Verlag im Georg Thieme Verlag Stuttgart · New York

Benign Hepatic Tumours

Benigne LebertumorenE. Biecker1 , 2 , H. P. Fischer3 , H. Strunk4 , T. Sauerbruch1
  • 1Medizinische Klinik und Poliklinik I, Universitätsklinikum Bonn
  • 2Institut für klinische Pharmakologie, Universität Bern, Schweiz
  • 3Institut für Pathologie, Universitätsklinikum Bonn
  • 4Klinik für Radiologie, Universitätsklinikum Bonn
Further Information

Publication History

Manuscript recieved: 25 January 2002

Accepted after revision: 28 June 2002

Publication Date:
19 February 2003 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Gutartige Lebertumoren umfassen ein großes Spektrum von regenerativen und echt-neoplastischen Prozessen. Fortschritte in den bildgebenden Verfahren wie NMR, CT und Sonographie sowie verbesserte Möglichkeiten der histologischen Untersuchung durch den Einsatz immunhistochemischer Verfahren ermöglichen die richtige Diagnose bei den meisten Patienten. Laparotomie und Resektion sind daher oft zu vermeiden. Die Differenzialdiagnose zwischen fokal-nodulärer Hyperplasie und hepatozellulärem Adenom ist klinisch am wichtigsten, da es beim hepatozellulären Adenom zur Ruptur und Blutung kommen kann. Das kavernöse Hämangiom, der häufigste benigne Lebertumor, muss fast nie behandelt werden. Die Diagnose der nodulär-regenerativen Hyperplasie gestaltet sich häufig schwierig und die Patienten werden erst durch Zeichen und Komplikationen der portalen Hypertension auffällig. Das seltene Angiomyolipom muss nicht behandelt werden. Die Relevanz besteht in der Abgrenzung zu malignen Prozessen. Auch der inflammatorische Pseudotumor kann zu Verwechslungen mit malignen Geschehen Anlass geben, da die klinischen Zeichen wie z.B. eine B-Symptomatik sich häufig gleichen. Therapeutische Optionen sind die medikamentöse Therapie oder ein chirurgisches Vorgehen. Das kindliche benigne Hämangioendotheliom ist selten, kann aber lebensgefährliche Komplikationen verursachen. Das Gallengangsadenom ist häufig eine Zufallsdiagnose, der keine klinische Bedeutung zukommt, wohingegen das biliäre Zystadenom oft symptomatisch wird und aufgrund der möglichen malignen Entartung reseziert werden muss.

Abstract

Benign hepatic tumours include a broad spectrum of regenerative and true neoplastic processes. Due to advances in imaging procedures like MRI, CT-scan and ultrasound as well as progress in immunohistochemistry, the appropriate diagnosis is made in a high percentage of patients without laparotomy and resection. Most important in clinical practice is the differential diagnosis of focal nodular hyperplasia and hepatocellular adenoma because of the risk of rupture and bleeding in the latter. Cavernous haemangioma, the most common benign hepatic tumour, rarely needs treatment. The diagnosis of nodular regenerative hyperplasia is often missed and patients present with secondary complications and signs of portal hypertension that necessitate treatment. The main problem in angiomyolipoma is to distinguish it from malignant processes which do require treatment. Because of its clinical presentation, inflammatory pseudotumour is also sometimes confused with a malignant tumour. Therapeutic options are drug therapy or surgical resection. Benign haemangioendothelioma of the infant is rare but may cause life-threatening complications. Bile duct adenoma is an incidental finding that is not known to cause any symptoms whereas biliary cystadenoma is often symptomatic and may progress to cystadenocarcinoma and therefore needs resection.

Schlüsselwörter

Gutartige Lebertumoren - kavernöses Hämangion - hepatozelluläres Adenom - fokal noduläre Hyperplasie - noduläre regenerative Hyperplasie - Angiomyolipom - infammatorischer Pseudotumor - benignes Hämangioendothelion - Gallengangsadenom - biliäres Zystadenom

Key words

Benign hepatic tumours - cavernous haemangioma - hepatocellular adenoma - focal nodular hyperplasia - nodular regenerative hyperplasia - angiomyolipoma - inflammatory pseudotumour - benign haemangioendothelioma - bile duct adenoma - biliary cystadenoma

References

  • 1 Ros P R, Li K C. Benign liver tumors.  Curr Probl Diagn Radiol. 1989;  18 125-155
    Google Scholar
  • 2 Ito K, Honjo K, Fujita T. et al . Liver neoplasms: diagnostic pitfalls in cross-sectional imaging.  Radiographics. 1996;  16 273-293
    Google Scholar
  • 3 Gedaly R, Pomposelli J J, Pomfret E A. et al . Cavernous hemangioma of the liver: anatomic resection vs. enucleation.  Arch Surg. 1999;  134 407-411
    Google Scholar
  • 4 Belli L, De Carlis L, Beati C. et al . Surgical treatment of symptomatic giant hemangiomas of the liver.  Surg Gynecol Obstet. 1992;  174 474-478
    Google Scholar
  • 5 Saegusa T, Ito K, Oba N. et al . Enlargement of multiple cavernous hemangioma of the liver in association with pregnancy.  Intern Med. 1995;  34 207-211
    Google Scholar
  • 6 Conter R L, Longmire W P Jr. Recurrent hepatic hemangiomas. Possible association with estrogen therapy.  Ann Surg. 1988;  207 115-119
    Google Scholar
  • 7 Takahashi T, Kuwao S, Katagiri H. et al . Multiple liver hemangiomas enlargement during long-term steroid therapy for myasthenia gravis.  Dig Dis Sci. 1998;  43 1553-1561
    Google Scholar
  • 8 Baker E R, Manders E, Whitney C W. Growth of cavernous hemangioma with puberty.  Clin Pediatr (Phila). 1985;  24 596-598
    Google Scholar
  • 9 Brunt E M. Benign tumors of the liver.  Clin Liver Dis. 2001;  5 1-15, v
    Google Scholar
  • 10 Trotter J F, Everson G T. Benign focal lesions of the liver.  Clin Liver Dis. 2001;  5 17-42, v
    Google Scholar
  • 11 Pol B, Disdier P, Le T reut YP. et al . Inflammatory process complicating giant hemangioma of the liver: report of three cases.  Liver Transpl Surg. 1998;  4 204-207
    Google Scholar
  • 12 Hall G W. Kasabach-Merritt syndrome: pathogenesis and management.  Br J Haematol. 2001;  112 851-862
    Google Scholar
  • 13 Hochwald S N, Blumgart L H. Giant hepatic hemangioma with Kasabach-Merritt syndrome: is the appropriate treatment enucleation or liver transplantation?.  HPB Surg. 2000;  11 413-419
    Google Scholar
  • 14 Bree R L, Schwab R E, Glazer G M. et al . The varied appearances of hepatic cavernous hemangiomas with sonography, computed tomography, magnetic resonance imaging and scintigraphy.  Radiographics. 1987;  7 1153-1175
    Google Scholar
  • 15 Perkins A B, Imam K, Smith W J. et al . Color and power Doppler sonography of liver hemangiomas: a dream unfulfilled?.  J Clin Ultrasound. 2000;  28 159-165
    Google Scholar
  • 16 Quinn S F, Benjamin G G. Hepatic cavernous hemangiomas: simple diagnostic sign with dynamic bolus CT.  Radiology. 1992;  182 545-548
    Google Scholar
  • 17 Soyer P, Dufresne A C, Somveille E. et al . Differentiation between hepatic cavernous hemangioma and malignant tumor with T2-weighted MRI: comparison of fast spin-echo and breathhold fast spin-echo pulse sequences.  Clin Imaging. 1998;  22 200-210
    Google Scholar
  • 18 Prakash R, Jena A, Behari V. et al . Technetium-99m red blood cell scintigraphy in diagnosis of hepatic hemangioma.  Clin Nucl Med. 1987;  12 235-237
    Google Scholar
  • 19 Kinnard M F, Alavi A, Rubin R A. et al . Nuclear imaging of solid hepatic masses.  Semin Roentgenol. 1995;  30 375-395
    Google Scholar
  • 20 Tung G A, Cronan J J. Percutaneous needle biopsy of hepatic cavernous hemangioma.  J Clin Gastroenterol. 1993;  16 117-122
    Google Scholar
  • 21 Nakaizumi A, Iishi H, Yamamoto R. et al . Diagnosis of hepatic cavernous hemangioma by fine needle aspiration biopsy under ultrasonic guidance.  Gastrointest Radiol. 1990;  15 39-42
    Google Scholar
  • 22 Farges O, Daradkeh S, Bismuth H. Cavernous hemangiomas of the liver: are there any indications for resection?.  World J Surg. 1995;  19 19-24
    Google Scholar
  • 23 Reddy K R, Kligerman S, Levi J. et al . Benign and solid tumors of the liver: relationship to sex, age, size of tumors, and outcome.  Am Surg. 2001;  67 173-178
    Google Scholar
  • 24 Hotokezaka M, Kojima M, Nakamura K. et al . Traumatic rupture of hepatic hemangioma.  J Clin Gastroenterol. 1996;  23 69-71
    Google Scholar
  • 25 Klompmaker I J, Sloof M J, van der Meer J. et al . Orthotopic liver transplantation in a patient with a giant cavernous hemangioma of the liver and Kasabach-Merritt syndrome.  Transplantation. 1989;  48 149-151
    Google Scholar
  • 26 Longeville J H, de la Hall P, Dolan P. et al . Treatment of a giant haemangioma of the liver with Kasabach-Merritt syndrome by orthotopic liver transplant a case report.  HPB Surg. 1997;  10 159-162
    Google Scholar
  • 27 Hanazaki K, Kajikawa S, Matsushita A. et al . Risk factors associated with intra-operative blood loss in hepatectomized patients with giant cavernous hemangioma of the liver.  Hepatogastroenterology. 1999;  46 1089-1093
    Google Scholar
  • 28 Srivastava D N, Gandhi D, Seith A. et al . Transcatheter arterial embolization in the treatment of symptomatic cavernous hemangiomas of the liver: a prospective study.  Abdom Imaging. 2001;  26 510-514
    Google Scholar
  • 29 Suzuki H, Nimura Y, Kamiya J. et al . Preoperative transcatheter arterial embolization for giant cavernous hemangioma of the liver with consumption coagulopathy.  Am J Gastroenterol. 1997;  92 688-691
    Google Scholar
  • 30 Tsai M K, Lee P H, Tung B S. et al . Experiences in surgical management of cavernous hemangioma of the liver.  Hepatogastroenterology. 1995;  42 988-992
    Google Scholar
  • 31 Bioulac-Sage P, Balabaud C, Wanless I R. Diagnosis of focal nodular hyperplasia: not so easy.  Am J Surg Pathol. 2001;  25 1322-1325
    Google Scholar
  • 32 Klatskin G. Hepatic tumors: possible relationship to use of oral contraceptives.  Gastroenterology. 1977;  73 386-394
    Google Scholar
  • 33 Mathieu D, Kobeiter H, Maison P. et al . Oral contraceptive use and focal nodular hyperplasia of the liver.  Gastroenterology. 2000;  118 560-564
    Google Scholar
  • 34 Weimann A, Mossinger M, Fronhoff K. et al . Pregnancy in women with observed focal nodular hyperplasia of the liver.  Lancet. 1998;  351 1251-1252
    Google Scholar
  • 35 Colle I, de Beeck B O, Hoorens A. et al . Multiple focal nodular hyperplasia.  J Gastroenterol. 1998;  33 904-908
    Google Scholar
  • 36 Sadowski D C, Lee S S, Wanless I R. et al . Progressive type of focal nodular hyperplasia characterized by multiple tumors and recurrence.  Hepatology. 1995;  21 970-975
    Google Scholar
  • 37 Schild H, Kreitner K F, Thelen M. et al . [Focal nodular hyperplasia of the liver in 930 patients].  ROFO Fortschr Geb Rontgenstr Nuklearmed. 1987;  147 612-618
    Google Scholar
  • 38 Brunt E M, Flye M W. Infarction in focal nodular hyperplasia of the liver. A case report.  Am J Clin Pathol. 1991;  95 503-506
    Google Scholar
  • 39 Fukukura Y, Nakashima O, Kusaba A. et al . Angioarchitecture and blood circulation in focal nodular hyperplasia of the liver.  J Hepatol. 1998;  29 470-475
    Google Scholar
  • 40 Fischer H P, Lankes G. Morphologic correlation between liver epithelium and mesenchyme allows insight into histogenesis of focal nodular hyperplasia (FNH) of the liver.  Virchows Arch B Cell Pathol Incl Mol Pathol. 1991;  60 373-380
    Google Scholar
  • 41 Gaffey M J, Iezzoni J C, Weiss L M. Clonal analysis of focal nodular hyperplasia of the liver.  Am J Pathol. 1996;  148 1089-1096
    Google Scholar
  • 42 Knowles D M, Wolff M. Focal nodular hyperplasia of the liver: a clinicopathologic study and review of the literature.  Hum Pathol. 1976;  7 533-545
    Google Scholar
  • 43 Cherqui D, Rahmouni A, Charlotte F. et al . Management of focal nodular hyperplasia and hepatocellular adenoma in young women: a series of 41 patients with clinical, radiological, and pathological correlations.  Hepatology. 1995;  22 1674-1681
    Google Scholar
  • 44 Harvey C J, Albrecht T. Ultrasound of focal liver lesions.  Eur Radiol. 2001;  11 1578-1593
    Google Scholar
  • 45 Golli M, Mathieu D, Anglade M C. et al . Focal nodular hyperplasia of the liver: value of color Doppler US in association with MR imaging.  Radiology. 1993;  187 113-117
    Google Scholar
  • 46 Uggowitzer M M, Kugler C, Mischinger H J. et al . Echo-enhanced Doppler sonography of focal nodular hyperplasia of the liver.  J Ultrasound Med. 1999;  18 445-451; quiz 453-454
    Google Scholar
  • 47 Ruppert-Kohlmayr A J, Uggowitzer M M, Kugler C. et al . Focal nodular hyperplasia and hepatocellular adenoma of the liver: differentiation with multiphasic helical CT.  AJR Am J Roentgenol. 2001;  176 1493-1498
    Google Scholar
  • 48 Kacl G M, Hagspiel K D, Marincek B. Focal nodular hyperplasia of the liver: serial MRI with Gd-DOTA, superparamagnetic iron oxide, and Gd-EOB-DTPA.  Abdom Imaging. 1997;  22 264-267
    Google Scholar
  • 49 Boulahdour H, Cherqui D, Charlotte F. et al . The hot spot hepatobiliary scan in focal nodular hyperplasia.  J Nucl Med. 1993;  34 2105-2110
    Google Scholar
  • 50 Foster J H. Benign liver tumours. Blumgart LH Surgery of the liver and biliary tract New York; Churchill Livingstone 1994 Vol. 2
    Google Scholar
  • 51 Kerlin P, Davis G L, McGill D B. et al . Hepatic adenoma and focal nodular hyperplasia: clinical, pathologic, and radiologic features.  Gastroenterology. 1983;  84 994-1002
    Google Scholar
  • 52 Rooks J B, Ory H W, Ishak K G. et al . Epidemiology of hepatocellular adenoma. The role of oral contraceptive use.  Jama. 1979;  242 644-648
    Google Scholar
  • 53 Nakao A, Sakagami K, Nakata Y. et al . Multiple hepatic adenomas caused by long-term administration of androgenic steroids for aplastic anemia in association with familial adenomatous polyposis.  J Gastroenterol. 2000;  35 557-562
    Google Scholar
  • 54 Labrune P, Trioche P, Duvaltier I. et al . Hepatocellular adenomas in glycogen storage disease type I and III: a series of 43 patients and review of the literature.  J Pediatr Gastroenterol Nutr. 1997;  24 276-279
    Google Scholar
  • 55 Baum J K, Bookstein J J, Holtz F. et al . Possible association between benign hepatomas and oral contraceptives.  Lancet. 1973;  2 926-929
    Google Scholar
  • 56 Kent D R, Nissen E D, Nissen S E. et al . Effect of pregnancy on liver tumor associated with oral contraceptives.  Obstet Gynecol. 1978;  51 148-151
    Google Scholar
  • 57 Scott L D, Katz A R, Duke J H. et al . Oral contraceptives, pregnancy, and focal nodular hyperplasia of the liver.  Jama. 1984;  251 1461-1463
    Google Scholar
  • 58 Scott F R, el-Refaie A, More L. et al . Hepatocellular carcinoma arising in an adenoma: value of QBend 10 immunostaining in diagnosis of liver cell carcinoma.  Histopathology. 1996;  28 472-474
    Google Scholar
  • 59 Ferrell L D. Hepatocellular carcinoma arising in a focus of multilobular adenoma. A case report.  Am J Surg Pathol. 1993;  17 525-529
    Google Scholar
  • 60 Mays E T, Christopherson W. Hepatic tumors induced by sex steroids.  Semin Liver Dis. 1984;  4 147-157
    Google Scholar
  • 61 Ribeiro A, Burgart L J, Nagorney D M. et al . Management of liver adenomatosis: results with a conservative surgical approach.  Liver Transpl Surg. 1998;  4 388-398
    Google Scholar
  • 62 Golli M, Van Nhieu J T, Mathieu D. et al . Hepatocellular adenoma: color Doppler US and pathologic correlations.  Radiology. 1994;  190 741-744
    Google Scholar
  • 63 Grazioli L, Federle M P, Ichikawa T. et al . Liver adenomatosis: clinical, histopathologic, and imaging findings in 15 patients.  Radiology. 2000;  216 395-402
    Google Scholar
  • 64 Arrive L, Flejou J F, Vilgrain V. et al . Hepatic adenoma: MR findings in 51 pathologically proved lesions.  Radiology. 1994;  193 507-512
    Google Scholar
  • 65 Herman P, Pugliese V, Machado M A. et al . Hepatic adenoma and focal nodular hyperplasia: differential diagnosis and treatment.  World J Surg. 2000;  24 372-376
    Google Scholar
  • 66 Shortell C K, Schwartz S I. Hepatic adenoma and focal nodular hyperplasia.  Surg Gynecol Obstet. 1991;  173 426-431
    Google Scholar
  • 67 Flowers B F, McBurney R P, Vera S R. Ruptured hepatic adenoma. A spectrum of presentation and treatment.  Am Surg. 1990;  56 380-383
    Google Scholar
  • 68 Belghiti J, Pateron D, Panis Y. et al . Resection of presumed benign liver tumours.  Br J Surg. 1993;  80 380-383
    Google Scholar
  • 69 Terkivatan T, de Wilt J H, de Man R A. et al . Treatment of ruptured hepatocellular adenoma.  Br J Surg. 2001;  88 207-209
    Google Scholar
  • 70 Ault G T, Wren S M, Ralls P W. et al . Selective management of hepatic adenomas.  Am Surg. 1996;  62 825-829
    Google Scholar
  • 71 Stolzel U, Tannapfel A, Wittekind C. et al . [Indications for liver biopsy in liver tumors].  Dtsch Med Wochenschr. 2000;  125 1041-1044
    Google Scholar
  • 72 Tannapfel A, Wittekind C. [Preneoplasia of the liver. Definition-differential diagnosis-clinical consequences].  Pathologe. 2001;  22 399-406
    Google Scholar
  • 73 Wanless I R. Micronodular transformation (nodular regenerative hyperplasia) of the liver: a report of 64 cases among 2,500 autopsies and a new classification of benign hepatocellular nodules.  Hepatology. 1990;  11 787-797
    Google Scholar
  • 74 Nakanuma Y. Nodular regenerative hyperplasia of the liver: retrospective survey in autopsy series.  J Clin Gastroenterol. 1990;  12 460-465
    Google Scholar
  • 75 Zhou H, Wolff M, Pauleit D. et al . Multiple macroregenerative nodules in liver cirrhosis due to Budd-Chiari syndrome. Case reports and review of the literature.  Hepatogastroenterology. 2000;  47 522-527
    Google Scholar
  • 76 Dumortier J, Boillot O, Chevallier M. et al . Familial occurrence of nodular regenerative hyperplasia of the liver: a report on three families.  Gut. 1999;  45 289-294
    Google Scholar
  • 77 Haboubi N Y, Smith V J, Coyne J D. et al . Nodular regenerative hyperplasia of the liver in a non-treated patient with mesangiocapillary glomerulonephritis.  Histopathology. 1991;  18 367-368
    Google Scholar
  • 78 Shimamatsu K, Wanless I R. Role of ischemia in causing apoptosis, atrophy, and nodular hyperplasia in human liver.  Hepatology. 1997;  26 343-350
    Google Scholar
  • 79 Washington K, Lane K L, Meyers W C. Nodular regenerative hyperplasia in partial hepatectomy specimens.  Am J Surg Pathol. 1993;  17 1151-1158
    Google Scholar
  • 80 Stromeyer F W, Ishak K G. Nodular transformation (nodular „regenerative” hyperplasia) of the liver. A clinicopathologic study of 30 cases.  Hum Pathol. 1981;  12 60-71
    Google Scholar
  • 81 Nzeako U C, Goodman Z D, Ishak K G. Hepatocellular carcinoma and nodular regenerative hyperplasia: possible pathogenetic relationship.  Am J Gastroenterol. 1996;  91 879-884
    Google Scholar
  • 82 Loinaz C, Colina F, Musella M. et al . Orthotopic liver transplantation in 4 patients with portal hypertension and non-cirrhotic nodular liver.  Hepatogastroenterology. 1998;  45 1787-1794
    Google Scholar
  • 83 Dachman A H, Ros P R, Goodman Z D. et al . Nodular regenerative hyperplasia of the liver: clinical and radiologic observations.  AJR Am J Roentgenol. 1987;  148 717-722
    Google Scholar
  • 84 Trauner M, Stepan K M, Resch M. et al . Diagnostic problems in nodular regenerative hyperplasia (nodular transformation) of the liver. Review of the literature and report of two cases.  Z Gastroenterol. 1992;  30 187-194
    Google Scholar
  • 85 Patriarche C, Pelletier G, Attali P. et al . Ultrasonography, angiography, computed tomography and magnetic resonance in nodular regenerative hyperplasia of the liver: report of a pseudo-tumoral case.  Radiat Med. 1988;  6 111-114
    Google Scholar
  • 86 Radomski J S, Chojnacki K A, Moritz M J. et al . Results of liver transplantation for nodular regenerative hyperplasia.  Am Surg. 2000;  66 1067-1070
    Google Scholar
  • 87 Dumortier J, Bizollon T, Scoazec J Y. et al . Orthotopic liver transplantation for idiopathic portal hypertension: indications and outcome.  Scand J Gastroenterol. 2001;  36 417-422
    Google Scholar
  • 88 Dachman A H, Lichtenstein J E, Friedman A C. et al . Infantile hemangioendothelioma of the liver: a radiologic-pathologic-clinical correlation.  AJR Am J Roentgenol. 1983;  140 1091-1096
    Google Scholar
  • 89 Diment J, Yurim O, Pappo O. Infantile Hemangioendothelioma of the Liver in an Adult.  Arch Pathol Lab Med. 2001;  125 931-932
    Google Scholar
  • 90 Selby D M, Stocker J T, Waclawiw M A. et al . Infantile hemangioendothelioma of the liver.  Hepatology. 1994;  20 39-45
    Google Scholar
  • 91 Braun P, Ducharme J C, Riopelle J L. et al . Hemangiomatosis of the liver in infants.  J Pediatr Surg. 1975;  10 121-126
    Google Scholar
  • 92 Dehner L P, Ishak K G. Vascular tumors of the liver in infants and children. A study of 30 cases and review of the literature.  Arch Pathol. 1971;  92 101-111
    Google Scholar
  • 93 Kaniklides C, Dimopoulos P A, Bajic D. Infantile hemangioendothelioma. A case report.  Acta Radiol. 2000;  41 161-164
    Google Scholar
  • 94 Keslar P J, Buck J L, Selby D M. From the archives of the AFIP. Infantile hemangioendothelioma of the liver revisited.  Radiographics. 1993;  13 657-670
    Google Scholar
  • 95 Sato M, Ishida H, Konno K. et al . Liver tumors in children and young patients: sonographic and color Doppler findings.  Abdom Imaging. 2000;  25 596-601
    Google Scholar
  • 96 Ezekowitz R A, Mulliken J B, Folkman J. Interferon alfa-2a therapy for life-threatening hemangiomas of infancy.  N Engl J Med. 1992;  326 1456-1463
    Google Scholar
  • 97 Burrows P E, Rosenberg H C, Chuang H S. Diffuse hepatic hemangiomas: percutaneous transcatheter embolization with detachable silicone balloons.  Radiology. 1985;  156 85-88
    Google Scholar
  • 98 McHugh K, Burrows P E. Infantile hepatic hemangioendotheliomas: significance of portal venous and systemic collateral arterial supply.  J Vasc Interv Radiol. 1992;  3 337-344
    Google Scholar
  • 99 Hurvitz S A, Hurvitz C H, Sloninsky L. et al . Successful treatment with cyclophosphamide of life-threatening diffuse hemangiomatosis involving the liver.  J Pediatr Hematol Oncol. 2000;  22 527-532
    Google Scholar
  • 100 Enjolras O, Riche M C, Merland J J. et al . Management of alarming hemangiomas in infancy: a review of 25 cases.  Pediatrics. 1990;  85 491-498
    Google Scholar
  • 101 Daller J A, Bueno J, Gutierrez J. et al . Hepatic hemangioendothelioma: clinical experience and management strategy.  J Pediatr Surg. 1999;  34 98-105; discussion 105-106
    Google Scholar
  • 102 Corbella F, Arico M, Podesta A F. et al . Infantile hepatic hemangioendothelioma treated by radiotherapy.  Pediatr Radiol. 1983;  13 297-300
    Google Scholar
  • 103 Nonomura A, Minato H, Kurumaya H. Angiomyolipoma predominantly composed of smooth muscle cells: problems in histological diagnosis.  Histopathology. 1998;  33 20-27
    Google Scholar
  • 104 Goodman Z D, Ishak K G. Angiomyolipomas of the liver.  Am J Surg Pathol. 1984;  8 745-750
    Google Scholar
  • 105 Nonomura A, Mizukami Y, Kadoya M. Angiomyolipoma of the liver: a collective review.  J Gastroenterol. 1994;  29 95-105
    Google Scholar
  • 106 Barnard M, Lajoie G. Angiomyolipoma: immunohistochemical and ultrastructural study of 14 cases.  Ultrastruct Pathol. 2001;  25 21-29
    Google Scholar
  • 107 Ahmadi T, Itai Y, Takahashi M. et al . Angiomyolipoma of the liver: significance of CT and MR dynamic study.  Abdom Imaging. 1998;  23 520-526
    Google Scholar
  • 108 Yeh C N, Chen M F, Hung C F. et al . Angiomyolipoma of the liver.  J Surg Oncol. 2001;  77 195-200
    Google Scholar
  • 109 Coffin C M, Humphrey P A, Dehner L P. Extrapulmonary inflammatory myofibroblastic tumor: a clinical and pathological survey.  Semin Diagn Pathol. 1998;  15 85-101
    Google Scholar
  • 110 Gollapudi P, Chejfec G, Zarling E J. Spontaneous regression of hepatic pseudotumor.  Am J Gastroenterol. 1992;  87 214-217
    Google Scholar
  • 111 Cheuk W, Chan J K, Shek T W. et al . Inflammatory pseudotumor-like follicular dendritic cell tumor: a distinctive low-grade malignant intra-abdominal neoplasm with consistent Epstein-Barr virus association.  Am J Surg Pathol. 2001;  25 721-731
    Google Scholar
  • 112 Shek T W, Liu C L, Peh W C. et al . Intra-abdominal follicular dendritic cell tumour: a rare tumour in need of recognition.  Histopathology. 1998;  33 465-470
    Google Scholar
  • 113 Selves J, Meggetto F, Brousset P. et al . Inflammatory pseudotumor of the liver. Evidence for follicular dendritic reticulum cell proliferation associated with clonal Epstein-Barr virus.  Am J Surg Pathol. 1996;  20 747-753
    Google Scholar
  • 114 Zavaglia C, Barberis M, Gelosa F. et al . Inflammatory pseudotumour of the liver with malignant transformation. Report of two cases.  Ital J Gastroenterol. 1996;  28 152-159
    Google Scholar
  • 115 Shek T W, Ho F C, Ng I O. et al . Follicular dendritic cell tumor of the liver. Evidence for an Epstein-Barr virus-related clonal proliferation of follicular dendritic cells.  Am J Surg Pathol. 1996;  20 313-324
    Google Scholar
  • 116 Shek T W, Ng I O, Chan K W. Inflammatory pseudotumor of the liver. Report of four cases and review of the literature.  Am J Surg Pathol. 1993;  17 231-238
    Google Scholar
  • 117 Flisak M E, Budris D M, Olson M C. et al . Inflammatory pseudotumor of the liver: appearance on MRI.  Clin Imaging. 1994;  18 1-3
    Google Scholar
  • 118 Ishida H, Tatsuta M, Furukawa H. et al . Multiple inflammatory pseudotumors mimicking liver metastasis from colon cancer: report of a case.  Surg Today. 2000;  30 530-533
    Google Scholar
  • 119 Noi I, Loberant N, Cohen I. Inflammatory pseudotumor of the liver.  Clin Imaging. 1994;  18 283-285
    Google Scholar
  • 120 Jais P, Berger J F, Vissuzaine C. et al . Regression of inflammatory pseudotumor of the liver under conservative therapy.  Dig Dis Sci. 1995;  40 752-756
    Google Scholar
  • 121 Li G H, Li J Q, Lin Y Z. Inflammatory pseudotumor of the liver.  J Surg Oncol. 1989;  42 244-248
    Google Scholar
  • 122 Mangiante G L, Colombari R, Portuese A. et al . Inflammatory pseudotumor of the liver: case report and review of the literature.  G Chir. 1997;  18 417-420
    Google Scholar
  • 123 Karhunen P J. Benign hepatic tumours and tumour like conditions in men.  J Clin Pathol. 1986;  39 183-188
    Google Scholar
  • 124 Bhathal P S, Hughes N R, Goodman Z D. The so-called bile duct adenoma is a peribiliary gland hamartoma.  Am J Surg Pathol. 1996;  20 858-864
    Google Scholar
  • 125 Govindarajan S, Peters R L. The bile duct adenoma. A lesion distinct from Meyenburg complex.  Arch Pathol Lab Med. 1984;  108 922-924
    Google Scholar
  • 126 Allaire G S, Rabin L, Ishak K G. et al . Bile duct adenoma. A study of 152 cases.  Am J Surg Pathol. 1988;  12 708-715
    Google Scholar
  • 127 Colombari R, Tsui W M. Biliary tumors of the liver.  Semin Liver Dis. 1995;  15 402-413
    Google Scholar
  • 128 Tajima T, Honda H, Kuroiwa T. et al . Radiologic features of intrahepatic bile duct adenoma: a look at the surface of the liver.  J Comput Assist Tomogr. 1999;  23 690-695
    Google Scholar
  • 129 Devaney K, Goodman Z D, Ishak K G. Hepatobiliary cystadenoma and cystadenocarcinoma. A light microscopic and immunohistochemical study of 70 patients.  Am J Surg Pathol. 1994;  18 1078-1091
    Google Scholar
  • 130 Wheeler D A, Edmondson H A. Cystadenoma with mesenchymal stroma (CMS) in the liver and bile ducts. A clinicopathologic study of 17 cases, 4 with malignant change.  Cancer. 1985;  56 1434-1445
    Google Scholar
  • 131 Subramony C, Herrera G A, Turbat-Herrera E A. Hepatobiliary cystadenoma. A study of five cases with reference to histogenesis.  Arch Pathol Lab Med. 1993;  117 1036-1042
    Google Scholar
  • 132 Lewis W D, Jenkins R L, Rossi R L. et al . Surgical treatment of biliary cystadenoma. A report of 15 cases.  Arch Surg. 1988;  123 563-568
    Google Scholar
  • 133 Thomas J A, Scriven M W, Puntis M C. et al . Elevated serum CA 19-9 levels in hepatobiliary cystadenoma with mesenchymal stroma. Two case reports with immunohistochemical confirmation.  Cancer. 1992;  70 1841-1846
    Google Scholar
  • 134 Choi B I, Lim J H, Han M C. et al . Biliary cystadenoma and cystadenocarcinoma: CT and sonographic findings.  Radiology. 1989;  171 57-61
    Google Scholar
  • 135 Jenkins R L, Johnson L B, Lewis W D. Surgical approach to benign liver tumors.  Semin Liver Dis. 1994;  14 178-189
    Google Scholar
  • 136 Thommesen N. Biliary hamartomas (von Meyenburg complexes) in liver needle biopsies.  Acta Pathol Microbiol Scand [A]. 1978;  86 93-99
    Google Scholar
  • 137 Ohta W, Ushio H. Histological reconstruction of a Von Meyenburg’s complex on the liver surface.  Endoscopy. 1984;  16 71-74
    Google Scholar
  • 138 Ramos A, Torres V E, Holley K E. et al . The liver in autosomal dominant polycystic kidney disease. Implications for pathogenesis.  Arch Pathol Lab Med. 1990;  114 180-184
    Google Scholar

Prof. Dr. T. Sauerbruch

Direktor der Medizinischen Klinik und Poliklinik I, Universitätsklinikum Bonn

Sigmund-Freud-Straße 25

53105 Bonn

Email: sauerbruch@uni-bonn.de