Histopathological Evaluation of Abnormal Hepatic Nodules Detected Radiologically and On Gross Examination of Hepatectomy Specimens and Their Relationship with Alpha Fetoprotein Levels

Abstract

Objective: To determine the frequency and pattern of abnormal nodules in Hepatectomy specimens and to evaluate the frequency of elevated serum alpha-fetoprotein (AFP) levels in abnormal hepatic nodules.

Methodology: A Descriptive, cross-sectional survey was conducted from January 2021 to July 2022 in the Department of Histopathology, Sheikh Zayed Hospital Lahore, A non-probability consecutive sampling technique was used. A total of 60 Hepatectomy samples taken from liver explants were included and data was analyzed by SPSS version 23. A chi-square test with a p-value less than 0.05 was considered significant.

Results: The mean age of patients was 47.33±14.74 years. There were 46 (76.67%) male and 14 (23.33%) female patients. On the frequency of etiology, 30 (50.00%) had viral etiology, 05 (8.33%) autoimmune, 06 (10.00%) cryptogenic, 03 (5.00%) NASH, 05 (8.33%) fibrolamellar CA, 07 (11.67%) bud chiari syndrome and 04 (6.67%) liver disease (Figure 4). There were 15 (25.00%) patients with elevated AFP levels. Abnormal nodules were present in 47 (78.33%) patients. On frequency of type of nodules, 11 (23.40%) macro-regenerative nodules, 04 (8.51%) FNH nodules, 06 (12.77%) adenoma nodules, 06 (12.77%) dysplastic nodules (SCC), 08 (17.02%) dysplastic nodules (LCC) and 12 (25.53%) hepatocellular carcinoma.

Conclusion: Viral causes are commonest in liver explant samples. The common histopathological finding was that HCC was identified in 25.53% of cases, and macro-regenerative nodules were identified in 23.40% of patients.