Which of the following liver disorders is a compli¬cation associated with oral contraceptives?
Drug-induced hepatitis with fatty change
Cholangiocarcinoma
Cavernous hemangiomas
Intrahepatic cholestasis
Oral contraceptives produce an intrahepatic cholestasis that is unpredictable (not related to the dose). The incidence of liver cell adenomas is also increased as a result of oral contraceptive use. These vascular tumors have a tendency to rupture during pregnancy, particu­larly those in a subcapsular location.
A purported increase in the incidence of focal nodu­lar hyperplasia (FNH) is associated with oral contra­ceptive use. Grossly, FNH is characterized by a poorly encapsulated nodule that has a lighter color than the surrounding hepatic parenchyma. On cut section, a centrally located stellate scar radiates out to the periph­ery of the lesion. Microscopically, the hepatocytes be­tween the scar tissue are normal.
A slightly increased risk for hepatocellular carci­noma is another effect of birth control pills on the liver.
Oral contraceptives are not associated with drug-induced hepatitis with fatty change, cholangiocarci­noma, cavernous hemangiomas, or fulminant hepatic failure.