A Tale of Two Benign Hepatic Nodules with Pulmonary Hypertension

Nodular regenerative hyperplasia and hepatocellular adenoma are two benign liver lesions with low risk of malignant potential. Nodular regenerative hyperplasia appears to be result of adaptive reaction to hepatic vasculopathy. Hepatocellular adenoma is associated with use of estrogen, anabolic steroids, metabolic disease and rarely vascular abnormality. We report an unusual case of a young female who presented with progressive dyspnoea, cough and edema. She succumbed to her illness within two days of her hospital stay. A medical autopsy was performed which revealed hepatocellular adenoma arising on the background of nodular regenerative hyperplasia along with pulmonary hypertension and intrapulmonary hemorrhage. Unusual case of nodular regenerative hyperplasia and hepatocellular adenoma associated with pulmonary hypertension where vascular pathology is suggested as a common event in their pathogenesis. Hence, it is advisable to rule out associated conditions with the help of imaging techniques in patients with pulmonary hypertension.