Primary hepatocellular tumours during long-term androgenic steroid therapy. A light and electron microscopic study of 11 cases with emphasis on microvasculature of the tumours

Abstract

11 liver tumours in connection with long-term androgen therapy were reported. Tumours included two benign adenomas, one adenoma with malignant transformation and 8 hepatocellular carcinomas. In three cases, metastases were present. Light microscopic studies revealed "dark" and "light" areas. "Light" cells contained a large amount of glycogen. In two tumours, angiosarcomatous transformation was observed. The electron microscopic examinations showed peculiar vasculature of the tumours. Blood cavities resembling peliosis hepatis were present where the endothelial cells were missing and the cavities were lined with rounded hepatocytes. Another vascular change was the capillarization of sinusoids. Several layers of basement membrane were found around the endothelial cells. The tumours associated with androgens were compared with 16 cases of focal nodular hyperplasia in young women on oral contraceptives. The differences and similarities between the two steroid-related tumours were discussed . The necessity to be familiar with the morphology of liver tumours associated with androgens was emphasized because of their marked tendency to bleed and their frequent malignant transformation.