Diagnosis of incidental findings such as hepatocellular carcinoma (HCC), cholangiocarcinoma, focal or massive necrosis, etc. is important as the type, number and correlation of these lesions with other etiologies of cirrhosis strongly influence patient management.
Method: In a prospective manner, we reviewed pre-transplantation and post transplantation pathologic reports of all patients whose livers were transplanted from May 1994 to June 2006 in Namazee hospital (The only liver transplant center of Iran).
Results: Among all 223 patients studied, only 14 incidental pathologic findings were detected. (Necrosis: 4, HCC: 3, Portal vein thrombosis: 2, cholangiocarcinoma: 1, Multiple liver cell adenoma: 1, Hemangioma: 1, large cell dysplasia: 1). Only two cases out of 14 had the same pathologic reports before transplantation. Hepatitis B was diagnosed for 2 patients who had HCC. Autoimmune hepatitis was diagnosed for one of the necrotic livers in pre-operation evaluation, while cryptogenic cirrhosis was reported for other 3 necrotic livers. In 2 cases who were infected with type B hepatitis, portal vein thrombosis was presented in post-transplantation reports, incidentally. Incidental pathologic findings are not common reports in our center. Between these rare presentations, necrotic liver was the most common incidental finding and HCC was the second.