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Semin Liver Dis 2013; 33(02): 178-184
DOI: 10.1055/s-0033-1345720
Diagnostic Problems in Hepatology
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Telangiectatic Hyperplastic Nodule Associated with Vascular Malformation in a Patient with Chronic Hepatitis B: Radiologic and Pathologic Features

Gonzalo Carrasco
1   Division of Liver Pathology, Department of Pathology, The Lillian and Henry Stratton - Hans Popper, Icahn School of Medicine at Mount Sinai, New York, New York
,
Cecilia Besa
2   Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York
,
Sara C. Lewis
2   Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York
,
Hena S. Kadri
3   Division of Surgical Oncology, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
,
Spiros Hiotis
3   Division of Surgical Oncology, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
,
Swan N. Thung
1   Division of Liver Pathology, Department of Pathology, The Lillian and Henry Stratton - Hans Popper, Icahn School of Medicine at Mount Sinai, New York, New York
› Author Affiliations
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Publication History

Publication Date:
08 June 2013 (online)

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Abstract

Recognizing hepatocellular nodules that cannot be classified as typical for hepatocellular carcinoma, hepatocellular adenoma, or focal nodular hyperplasia is important, especially in a patient with high risk for hepatocellular carcinoma. The authors report a case of a 53-year-old man with chronic hepatitis B, who was referred to the hospital with a liver mass found on routine imaging follow-up. Abdominal ultrasound revealed a 2.4-cm hypoechoic lesion. Contrast computed tomography showed homogeneous arterial enhancement and mild hyperdensity on portal venous phase images. Due to the high risk for hepatocellular carcinoma, the patient underwent laparoscopic left lateral segmentectomy that revealed a 2.2-cm poorly defined red-brown lesion. The nodule was diagnosed as a hypervascular/telangiectatic hyperplastic hepatocellular nodule based on histopathologic findings and immunostaining profile with negative glutamine synthetase, diffuse positive CD34 highlighting hyperplastic endothelial cells along the telangiectatic sinusoids and dilated vascular channels, and CK7 and CK19 reactive normal bile ducts within the lesion.

Keywords

telangiectatic hyperplastic nodule - liver mass - chronic hepatitis B - benign mass - vascular malformation
 

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