Hepatocellular adenoma, approximately half and predominantly inflammatory subtype, in 38 Japanese patients with several differences in age, gender, and clinical background factors from Western populations

Asami Izu; Masahiko Sugitani; Noriko Kinukawa; Hiroshi Matsumura; Masahiro Ogawa; Mitsuhiko Moriyama; Shintaro Yamazaki; Tadatoshi Takayama; Hiroshi Hano; Takashi Yao; Hiroaki Kanda; Koyu Suzuki; Seisyu Hayashi; Syunichi Ariizumi; Masakazu Yamamoto; Yukio Morishita; Koshi Matsumoto; Naoya Nakamura; Masayuki Nakano

doi:10.1111/hepr.13613

Hepatocellular adenoma, approximately half and predominantly inflammatory subtype, in 38 Japanese patients with several differences in age, gender, and clinical background factors from Western populations

Hepatol Res. 2021 Mar;51(3):336-342. doi: 10.1111/hepr.13613. Epub 2021 Feb 22.

Authors

Asami Izu^{1

2}, Masahiko Sugitani^{1

3}, Noriko Kinukawa^{1

3}, Hiroshi Matsumura⁴, Masahiro Ogawa⁴, Mitsuhiko Moriyama⁴, Shintaro Yamazaki⁵, Tadatoshi Takayama⁵, Hiroshi Hano⁶, Takashi Yao⁷, Hiroaki Kanda^{8

9}, Koyu Suzuki¹⁰, Seisyu Hayashi¹¹, Syunichi Ariizumi¹², Masakazu Yamamoto¹², Yukio Morishita¹³, Koshi Matsumoto¹⁴, Naoya Nakamura¹⁵, Masayuki Nakano¹⁶

Affiliations

¹ Department of Pathology, Nihon University School of Medicine, Tokyo, Japan.
² Department of Diagnostic Pathology, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan.
³ Department of Diagnostic Pathology, Ageo Central General Hospital, Ageo, Saitama, Japan.
⁴ Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
⁵ Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan.
⁶ Department of Pathology, Jikei University School of Medicine, Tokyo, Japan.
⁷ Department of Human Pathology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
⁸ Department of Pathology, The Cancer Institute of Japanese Foundation for Cancer Research, Tokyo, Japan.
⁹ Department of Pathology, Saitama Cancer Center, Ina, Saitama, Japan.
¹⁰ Department of Pathology, Saint Luke's International Hospital, Tokyo, Japan.
¹¹ Department of Internal Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan.
¹² Department of Gastroenterological Surgery, Tokyo Women's Medical University, Tokyo, Japan.
¹³ Diagnostic Pathology Division, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan.
¹⁴ Pathology Division, Ebina General Hospital, Ebina, Kanagawa, Japan.
¹⁵ Department of Pathology, Tokai University School of Medicine, Isehara, Kanagawa, Japan.
¹⁶ Tokyo Central Pathology Laboratory, Tokyo, Japan.

PMID: 33381872
DOI: 10.1111/hepr.13613

Abstract

Aim: Hepatocellular adenoma (HCA) has a lower prevalence in Japan than in Western countries and HCA subtypes have been reported for only a few Japanese patients. We analyzed HCA subtype data 38 patients from 23 hospitals in Japan in order to examine character and difference between Western countries.

Methods: To confirm HCA and to analyze subtypes, we performed immunohistochemical examinations.

Results: Thirty-eight cases were found to have HCA without cirrhosis. The male/female ratio was 18/20. Ages ranged from 15 to 79 (average, 43.2) years. Male and elder patients are not rare, furthermore, most of elder patients are male. Glycogen storage disease, past history of medicament use, hepatitis B virus surface antigen-positivity, antihepatitis C virus -positivity, diabetes mellitus, obesity, lipid metabolism disorder and alcoholism were present in of 6, 8, 1, 1, 6, 6, 4, and 6 cases, respectively. As to HCA subtypes, HNF1alpha-inactivated HCA, beta-catenin activated HCA (b-HCA), inflammatory HCA (IHCA) and unclassified HCA (U-HCA) accounted for nine (23.7%), four (10.5%), 17 (44.7%) and eight (21.1%) cases, respectively. Two cases showed coexistence of HCA and hepatocellular carcinoma (HCC) at surgery, and another had HCC which had been detected 23 years after HCA diagnosis. The HCA subtype of one of the former cases was U-HCA, while the remaining two had b-HCA and U-HCA.

Conclusions: In Japanese HCA cases, the proportions of U-HCA, male and elder cases were slightly higher than in Western countries, and most of elder patients were male. IHCA was however common regardless of race, and was assumed to be the predominant subtype of HCA.

Keywords: WHO classification; epidemiology; hepatocellular adenoma; subtype.