Mesenchymal hamartoma of liver. A regional ischemic lesion of a sequestered lobe
W. J. Lennington, G. F. Gray Jr and D. L. Page
Department of Pathology, Vanderbilt University Medical Center, Nashville, Tenn. 37232.
OBJECTIVE--To evaluate histologic and gross features of mesenchymal
hamartoma of liver and similar lesions in relation to determining likely
pathogenesis. DESIGN--Case series of patients presenting to a tertiary care
hospital over 16 years. PATIENTS--Three children with mesenchymal hamartoma
ranging from newborn to 11 months of age and one 12-year-old girl with
torsion of an accessory lobe of liver. MAIN OUTCOME MEASURES--Similarity of
gross vascular and segmented anomalies as well as apparent consequent
histologic features of mesenchymal hamartoma to those of torsion of an
accessory lobe of liver indicate that they are pathogenetically related.
RESULTS--Dissecting microscopic examination revealed a single vascular
supply in one case and remote thrombi in two cases of mesenchymal hamartoma
evaluated. The histologic features of mesenchymal hamartoma (hypocellular
central zone and hypercellular periphery) were duplicated in the lobe of
liver with torsion. CONCLUSIONS--Mesenchymal hamartoma represents a lesion
with an anomalous solitary vascular supply that may evolve into its
specific pattern with stromal cysts as a result of early ischemic changes.
