Kondo F
Department of Molecular Pathology, Chiba University School of Medicine, Chiba, Japan.
J Gastroenterol Hepatol. 2001 Dec;16(12):1319-28. doi: 10.1046/j.1440-1746.2001.02576.x.
Problems in definitive diagnosis and etiology of various benign nodular hepatocellular lesions were evaluated. Of these lesions, focal nodular hyperplasia (FNH), nodular regenerative hyperplasia (NRH), nodular lesions associated with idiopathic portal hypertension (IPH), non-cirrhotic large regenerative nodules (LRN), hepatocellular adenoma (HA)-like hyperplastic nodules, and partial nodular transformation (PNT) have been suggested to be related to abnormal hepatic circulation. However, the following points are considered to need further clarification: (i) is the abnormal circulation caused by thrombosis, vasculitis, or congenital anomaly?; (ii) is thrombosis a cause or a result of congestion?; (iii) are impaired blood vessels primarily the portal veins or arteries?; (iv) how are these disorders related to various syndromes, immunological abnormalities and abnormal blood flow of other organs, which are reported to coexist with these lesions often?; and (v) how should non-typical cases, which differ from typical cases, be interpreted? In addition, a concept that may lead to solving these problems (anomalous portal tract syndrome; a hypothesis that congenital vascular anomaly is the origin of these benign nodular hepatocellular lesions) was introduced.
对各种良性结节性肝细胞病变的明确诊断及病因方面的问题进行了评估。在这些病变中，局灶性结节性增生（FNH）、结节性再生性增生（NRH）、与特发性门静脉高压（IPH）相关的结节性病变、非肝硬化性大再生结节（LRN）、肝细胞腺瘤（HA）样增生结节以及部分结节性转化（PNT）已被认为与肝脏血液循环异常有关。然而，以下几点被认为需要进一步阐明：（i）异常循环是由血栓形成、血管炎还是先天性异常引起的？；（ii）血栓形成是充血的原因还是结果？；（iii）受损的血管主要是门静脉还是动脉？；（iv）这些疾病如何与各种综合征、免疫异常以及其他器官的异常血流相关，据报道这些常与这些病变共存？；以及（v）与典型病例不同的非典型病例应如何解释？此外，还引入了一个可能有助于解决这些问题的概念（异常门静脉综合征；一种先天性血管异常是这些良性结节性肝细胞病变起源的假说）。
