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392 seCtion iii Gastrointestinal ` gastrointestinal—PatHology Gastrointestinal ` gastrointestinal—PatHology
Hepatocellular Most common 1° malignant tumor of A B
carcinoma/hepatoma liver in adults A . Associated with HBV
(+/− cirrhosis) and all other causes of
cirrhosis (including HCV, alcoholic and
nonalcoholic fatty liver disease, autoimmune
disease, hemochromatosis, Wilson disease,
α -antitrypsin deficiency) and specific
1
carcinogens (eg, aflatoxin from Aspergillus).
May lead to Budd-Chiari syndrome.
Findings: jaundice, tender hepatomegaly,
ascites, polycythemia, anorexia. Spreads
hematogenously.
Diagnosis: α-fetoprotein; ultrasound or
contrast CT/MRI B , biopsy.
Other liver tumors
Angiosarcoma Malignant tumor of endothelial origin; associated with exposure to arsenic, vinyl chloride.
Cavernous Most common benign liver tumor (venous malformation) A ; typically occurs at age 30–50 years.
hemangioma Biopsy contraindicated because of risk of hemorrhage.
A
Hepatic adenoma Rare, benign liver tumor, often related to oral contraceptive or anabolic steroid use; may regress
spontaneously or rupture (abdominal pain and shock).
Metastases GI malignancies, breast and lung cancer. Most common overall; metastases are rarely solitary.
Budd-Chiari syndrome Thrombosis or compression of hepatic veins with centrilobular congestion and necrosis
congestive liver disease (hepatomegaly, ascites, varices, abdominal pain, liver failure). Absence
of JVD. Associated with hypercoagulable states, polycythemia vera, postpartum state, HCC. May
cause nutmeg liver (mottled appearance).
α -antitrypsin Misfolded gene product protein aggregates in In lungs, α -antitrypsin uninhibited elastase
1
1
deficiency hepatocellular ER cirrhosis with in alveoli elastic tissue panacinar
A PAS ⊕ globules A in liver. Codominant trait. emphysema.
Often presents in young patients with liver
damage and dyspnea without a history of
smoking.
FAS1_2019_09-Gastrointestinal.indd 392 11/7/19 4:42 PM
