Which of the following is true about Nodular Regenerative Hyperplasia?
Ans: (c) Portal hypertension seen in 50% of patientsRef: Robbins Pathology, 9th editionFeatures of Nodular Regenerative Hyperplasia of LiverNodular hyperplasia diffusely affecting entire liver but with no / minimal fibrous septaDevelops at all ages but usually symptomatic at age 40+Associated with:Portal hypertensionConnective tissue disease (rheumatoid arthritis, polyarteritis nodosa)Myeloproliferative disordersLymphoproliferative disordersVascular disordersChemotherapyImmunosuppressive drugsAST - ALT mild elevation or normalPresents as non-cirrhotic portal hypertensionPathology (Gross and Microscopy)1-3 mm diameter nodulesNo fibrosis, only nodulesOn biopsy, apparent lack of central veins and presence of curvilinear areas of congestion are suggestiveReticulin stain highlights the fibrous nature
Nodule size 0.1 to 1 cm
Fibrosis septa present
Portal hypertension seen in 50% of patients
AST and ALT are markedly elevated
Cellular Pathology