A cytokeratin‐immunohistochemical study of focal nodular hyperplasia of the liver: further evidence that ductular metaplasia of hepatocytes contributes to ductular “proliferation”

Abstract
— A cytokeratin-immunohistochemical study was performed on eight specimens of focal nodular hyperplasia of the liver in order to determine whether hepatocytes in this lesion can express “bile duct type” cytokeratins. Serially cut cryostat sections were reacted with a panel of six monoclonal antibodies specifically reactive with cytokeratin polypeptides nr. 7, 8, 18 and 19, using a 3-step immunoperoxidase procedure. Hepatocytes were positive for cytokeratins nr. 8 and nr. 18, whereas ductules contained in addition to cytokeratins nr. 8 and nr. 18 also polypeptides nr. 7 and nr. 19. In all cases, a variable number of hepatocytes close to fibrous septa or inside the nodules expressed cytokeratin nr. 7. In four cases, a small number of hepatocytes were also immunoreactive for cytokeratin nr. 19. Our data demonstrate that hepatocytes in focal nodular hyperplasia can express one or even two “bile duct type” cytokeratins, supporting the concept that ductular metaplasia of hepatocytes contributes to the ductular “proliferation” observed in this tumor-like lesion.