Multiple macroregenerative nodules in liver cirrhosis due to Budd-Chiari syndrome. Case reports and review of the literature

Clinical, radiological, histological and immunohistochemical methods were u sed to define the nature of multiple rapidly growing hepatic nodules in 2 y oung patients with Budd-Chiari syndrome due to myeloproliferative diseases. In one patient, the arterial hyperperfusion of large nodules was demonstra ted by dynamic computed tomography and angiography. The explanted livers of these patients showed multiple well-demarcated nodules up to 3cm in diamet er on the background of liver cirrhosis resulting from chronic hepatic cong estion. Histologically, these nodules covered a spectrum ranging from adeno ma-like lesions to nodulers resembling focal nodular hyperplasia. They cons isted of essentially normal hepatocytes, and variably contained fibrous sep ta including neoductules and large, mostly dysmorphic arteries. Sometimes, they were located close to still patent or recanalized veins. These rapidly growing hepatic nodules are best defined as macroregenerative nodules. The knowledge of this entity may help the physician to avoid misinterpretation of such nodules as carcinomas.