Epidemiological and clinical aspects of focal nodular hyperplasia of the liver. An assessment of 886 cases

Abstract

The objective of this study was to check whether there is a link between focalnodular hepatic hyperplasia of the liver and use of birth control pills, and if so, what it is. Focalnodular hepatic hyperplasias consists of hepatocytes, Kupffer's cells, proliferating hepatic ducts, connective tissue and vessels. Characteristically, on the cut surface of a focalnodular hyperplasia specimen is central, star shaped scar tissue with radial branches. The nodular tissue is sharply delineated from the surrounding liver tissue without actually forming an anatomic capsule. Based on the literature and authors' observations 886 cases were assembled for analysis. Results are as follows: Roughly 20% of tumors occur in children and adolescents, barely 18% in males. Use of steroid hormones for contraceptive purposes was found in only 27.8% of patients. Tumor size does not correlate with length of use of birth control pills. In males and patients under 20, tumors are on the average larger than in women and patients over 19. On the other hand, birth control pills are assumed to promote growth of an existing focalnodular hyperplasia for the following reason: Women using oral contraceptives on the average have larger tumors than non-users; oral contraceptive users are younger than the comparison group when the diagnosis is made; symptoms occur more frequently among pill user; however, it is concluded that oral contraceptives can be precluded as a causal pathogenetic factor in focalnodular hyperplasia.