Definition: Nodular regenerative hyperplasia of the liver is defined by hepatocellular nodules distributed throughout the liver in the absence of fibrous septa between the nodules.
Nodular regenerative hyperplasia is a secondary and nonspecific tissue adaptation to heterogeneous distribution of blood flow and does not represent a specific entity. Approximately 50% of these patients develop portal hypertension.
Synopsis
characterized grossly by diffusely nodular liver resembling micronodular cirrhosis.
regenerative parenchyma without fibrosis, usually smaller than the hepatic lobule.
Variants
hepatic diffuse nodular hyperplasia in cirrhosis
possible familial occurrence
Associations
Budd-Chiari syndrome
congenital absence of portal vein
sickle cell anemia
hepatocellular carcinoma (HCC)
celiac disease
dysimmunity
- polyarteritis nodosa
- rheumatoid arthritis
- collagen vascular diseases (collagen diseases)
- Sjogren syndrome
- Schnitzler syndrome (urticaria, macroglobulinemia, sclerotic bone lesions)
- systemic lupus erythematosus
- antiphospholipid antibodies syndrome (antiphospholipid antibodies)
- systemic sclerosis
- Felty syndrome
6-thioguanine therapy
anticonvulsant drug therapy
Donohue syndrome
disseminated intravascular coagulation
angiomyolipoma of the kidney
renal allograft
azathioprine
hepatotoxic drugs
hematological malignancies
- lymphoproliferative disorders
- myeloproliferative disorders
sarcoidosis
Differential diagnosis
other nodular lesions of the liver
- cirrhosis
- partial nodular transformation
- focal nodular hyperplasia
- hepatocellular adenoma (hepatic adenoma)
See also
nodular transformation of the liver
- focal nodular hyperplasia
- partial nodular transformation
- cirrhosis telangiectasia hepatis
- nodular regenerative hyperplasia
References
Wanless IR. Micronodular transformation (nodular regenerative hyperplasia) of the liver: a report of 64 cases among 2,500 autopsies and a new classification of benign hepatocellular nodules. Hepatology. 1990 May;11(5):787-97. PMID: 2189821
