Benign liver tumours: understanding molecular physiology to adapt clinical management View Full Text


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Article Info

DATE

2022-07-14

AUTHORS

Jean-Charles Nault, Valérie Paradis, Maxime Ronot, Jessica Zucman-Rossi

ABSTRACT

Improvements in understanding the pathophysiology of the different benign liver nodules have refined their nosological classification. New criteria have been identified using imaging, histology and molecular analyses for a precise diagnosis of these tumours. Improvement in the classification of liver tumours provides a more accurate prediction of disease progression and has modified patient management. Haemangioma and focal nodular hyperplasia, the most common benign liver tumours that develop in the absence of chronic liver disease, are usually easy to diagnose on imaging and do not require specific treatment. However, hepatocellular adenomas and cirrhotic macronodules can be difficult to discriminate from hepatocellular carcinoma. The molecular subtyping of hepatocellular adenomas in five major subgroups defined by HNF1A inactivation, β-catenin mutation in exon 3 or exon 7/8, and activation of inflammatory or Hedgehog pathways helps to identify the tumours at risk of malignant transformation or bleeding. New clinical, biological and molecular tools have gradually been included in diagnostic and treatment algorithms to classify benign liver tumours and improve patient management. This Review aims to explain the main pathogenic mechanisms of benign liver tumours and how this knowledge could influence clinical practice. More... »

PAGES

703-716

References to SciGraph publications

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  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1038/s41575-022-00643-5

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    33 schema:description Improvements in understanding the pathophysiology of the different benign liver nodules have refined their nosological classification. New criteria have been identified using imaging, histology and molecular analyses for a precise diagnosis of these tumours. Improvement in the classification of liver tumours provides a more accurate prediction of disease progression and has modified patient management. Haemangioma and focal nodular hyperplasia, the most common benign liver tumours that develop in the absence of chronic liver disease, are usually easy to diagnose on imaging and do not require specific treatment. However, hepatocellular adenomas and cirrhotic macronodules can be difficult to discriminate from hepatocellular carcinoma. The molecular subtyping of hepatocellular adenomas in five major subgroups defined by HNF1A inactivation, β-catenin mutation in exon 3 or exon 7/8, and activation of inflammatory or Hedgehog pathways helps to identify the tumours at risk of malignant transformation or bleeding. New clinical, biological and molecular tools have gradually been included in diagnostic and treatment algorithms to classify benign liver tumours and improve patient management. This Review aims to explain the main pathogenic mechanisms of benign liver tumours and how this knowledge could influence clinical practice.
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    40 absence
    41 accurate prediction
    42 activation
    43 adenomas
    44 algorithm
    45 analysis
    46 benign liver
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    48 benign liver tumors
    49 bleeding
    50 carcinoma
    51 chronic liver disease
    52 classification
    53 clinical management
    54 clinical practice
    55 common benign liver tumor
    56 criteria
    57 diagnosis
    58 disease
    59 disease progression
    60 exon 3
    61 exon 7/8
    62 focal nodular hyperplasia
    63 hepatocellular adenoma
    64 hepatocellular carcinoma
    65 histology
    66 hyperplasia
    67 improvement
    68 inactivation
    69 knowledge
    70 liver
    71 liver disease
    72 liver nodules
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    74 macronodules
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    76 major subgroups
    77 malignant transformation
    78 management
    79 mechanism
    80 molecular analysis
    81 molecular physiology
    82 molecular subtyping
    83 molecular tools
    84 mutations
    85 new criterion
    86 nodular hyperplasia
    87 nodules
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