Focal nodular hyperplasia of the liver. Possible influence of female reproductive steroids on the histological picture.

Abstract

In a series of 18 patients with focal nodular hyperplasia of the liver characteristic histological changes were found in the lesion of 5 patients receiving female reproductive steroids, e.g, four women taking oral contraceptives for several years, and one man treated with synthetic estrogenic compound for carcinoma of the prostate. These lesions contained young, connective tissue septa with abundant proliferation of bile ducts, piecemeal necroses and lymphocytic infiltration. Much less or no activity, was found in the lesion of 11 women and 2 men without hormone treatment. Possible mechanisms for this activity are discussed, and it is proposed that focal nodular hyperplasia represents a congenital malformation, possibly a hamartoma, the liver cells of which may suffer from enzymatic defects, which may render them especially vulnerable to female sex hormones.