TASL practice guidance on the clinical assessment and management of patients with nonalcoholic fatty liver disease

Nonalcoholic fatty liver disease (NAFLD) is a multisystem disease and is significantly associated with obesity, insulin resistance, type 2 diabetes mellitus, metabolic syndrome, and cardiovascular disease. NAFLD has become the most prevalent chronic liver disease in Western countries, and the proportion of NAFLD-related cirrhosis among patients on liver transplantation waiting lists has increased. In light of the accumulated data about NAFLD, and to provide a common approach with multi-disciplines dealing with the subject, it has become necessary to create new guidance for diagnosing and treating NAFLD. This guidance was prepared following an interdisciplinary study under the leadership of the Turkish Association for the Study of the Liver (TASL), Fatty Liver Special Interest Group. This new TASL Guidance is a practical application guide on NAFLD and was prepared to standardize the clinical approach to diagnosing and treating NAFLD patients. This guidance reflects many advances in the field of NAFLD. The proposals in this guidance are meant to aid decision-making in clinical practice. The guidance is primar-ily intended for gastroenterology, endocrinology, metabolism diseases, cardi-ology, internal medicine, pediatric specialists, and family medicine specialists

Pathology of Hepatocellular Adenoma: Subtypes and Rare Morphologic Features

Background: The molecular classification has been divided HCA into four main subgroups: hepatocyte-nuclear-factor-1a mutated (H-HCA), B-catenin type (HA-B), inflammatory type (HA-I) and unclassified type. Those subgroups were linked with risk factors, clinical behavior, histological features, imaging and malignant transformation. Subtyping is useful to predict HA’s behavior and also to detect morphology which may have the potential to affect the prognosis. We aimed to review subtype features of our hepatocellular adenoma cases and discuss the importance of the rare morphologic features. Methods: Fifteen Hepatocellular adenoma cases (10 resections, 3 explants and 2 biopsies) were included in this study. Hematoxylin and eosin (H&E) stained slides, Reticulin and Masson’s trichrome stains, as well as immunohistochemical studies (IHC), were used to evaluate general morphologic and immunophenotypic features performed with B-catenin, SAA amyloid and Glutamine Synthetase(GS) using standard laboratory techniques in the Ventana Benchmark Ultra platform. CD34 immunohistochemical stains were performed on atypical cases to evaluate the presence of vascularization. Results: By morphologic features and Immunohistochemistry, 3 HA-B (%20), 4 HA-I (%26.6), 4 HA-H (%26.6) and 4 HA-U (%26.6) cases were classified. Two HA cases had Dubin-Johnson pigment and Two of the beta-catenin mutated HAs had bone marrow metaplasia. In one of the cases, malignant transformation in the HA was present. The microscopic findings included hemorrhage, pigment formation, granuloma formation, presence of inflammation, presence and degree of steatosis, preserved or non-preserved reticulin network. Conclusions: Besides the classic morphologic features; granuloma formation, pigmentation, bone marrow metaplasia can be seen in HAs. Although the prognostic significance of those is not known, they are considered to have a role in the development and progression of HA

Association of signal transducer and activator of transcription, interleukin-6, and interleukin-10 positivity with antiviral treatment in cirrhotic liver samples from patients with the hepatitis B or C virus

Objective: Terminal liver disease due to viral hepatitis infections is an important health problem. This study aimed to compare the expression of members of the signal transducer and activator of transcription (STAT) family (STAT-1, -2, -3, -5a, and -5b) and interleukin (IL)-6 and IL-10 in hepatectomy material from patients who received antiviral treatment and underwent a liver transplantation due to terminal liver failure. Methods: The study consisted of 45 patients who underwent a liver transplantation due to chronic liver failure associated with viral hepatitis (hepatitis C virus [HCV] or hepatitis B virus [HBV]). The patients were divided into three groups according to the drug treatments they received prior to the liver transplantation: Group A: lamivudine, Group B: adefovir, and Group C: interferon or interferon + ribavirin. Results: In the study population, 9 (20%) patients were females and 36 (80%) were males. The mean age was 45.7 (29–69) years. STAT-2, -3, and IL-6 expression were significantly higher in hepatocytes in Group A (p<0.05). Conclusion: High STAT-3, high IL-6, and low STAT-1 expression were associated with optimum hepatocyte regeneration and liver metabolic function. In this regard, lamivudine was the most effective drug in the present study

Hepatocellular adenomas in the Turkish population: reclassification according to updated World Health Organization criteria

Aims Hepatocellular adenoma (HCA) is an uncommon liver neoplasm, and studies of HCA subtypes have been primarily limited to France, the USA, and Japan. The aim of this study was to describe the clinicopathological features of HCA subtypes in Turkey

Hepatocellular adenomas in the Turkish population: reclassification according to updated World Health Organization criteria

Aims Hepatocellular adenoma (HCA) is an uncommon liver neoplasm, and studies of HCA subtypes have been primarily limited to France, the USA, and Japan. The aim of this study was to describe the clinicopathological features of HCA subtypes in Turkey

Can the use of reference pictures improve the interobserver variability on assessment of liver steatosis percentage: A digital platform based approach

WOS: 000408735401156