Extranodular background liver parenchyma of focal nodular hyperplasia: histopathological characteristics

Focal nodular hyperplasia (FNH) of the liver is considered to develop as a hyperplastic response to a preexisting vascular abnormality. From the pathogenic point of view, we studied histological alterations in the extranodular background liver tissue of FNH (FNH-bg-liver). We compared ten FNH-bg-livers with ten non-FNH cases (non-FNH-liver) and found small uniform nodule formations with ring-like siderosis in the FNH-bg-livers (4/7, 57%) but not in the non-FNH-livers. Abnormal small arteries not accompanied by portal tracts were observed in six of six FNH-bg-livers for which immunohistochemical study was available, while this was observed in only three of the ten non-FNH-livers. CD34-positive sinusoids around the portal tracts were observed in only the FNH-bg-livers (3/6, 50%). Further, two of ten FNH-bg-livers had ectopic pancreatic tissue. Ring-like siderosis, abnormal small arteries, CD34-positive sinusoids, and ectopic pancreatic tissue were characteristic in the extranodular background liver tissue in cases of FNH.