肝脏巨大局灶性结节性增生：有可能避免手术切除。

Large focal nodular hyperplasia of the liver: possible to evade surgical resection.

作者信息

Tanaka S, Hirohashi K, Tanaka H, Kubo S, Shuto T, Higaki I, Takemura S, Yamamoto T, Morimoto Y, Kinoshita H

机构信息

Department of Gastroenterological and Hepato-Biliary-Pancreatic Surgery, Osaka City University, Graduate School of Medicine, Japan.

出版信息

Osaka City Med J. 2001 Dec;47(2):189-94.

PMID:11906129

Abstract

PURPOSE

Although recent advances in diagnostic imaging have allowed a number of patients with focal nodular hyperplasia (FNH) to avoid surgical treatment, the natural course of large FNH is still unknown.

CASE REPORT

A 25-year-old man was admitted because of a large hepatic mass detected on routine examination in June 1998. The only laboratory abnormality was an elevated gamma-GTP. Computed tomography, angiography, positron emission tomography using F-18 fluorodeoxyglucose (FDG-PET), and scintigraphy using technetium-99m-galactosylneoglycoalbumin(99mTc-NGA) demonstrated a spoke-wheel appearance of vessels, normal hepatocytes, and no malignancy. Histologic findings on needle biopsy were consistent with FNH. After informed consent, the patient agreed to observation. Two years after the initial diagnosis, he has no symptoms, and there are no changes in the size or character of the lesion on computed tomography.

DISCUSSION

Careful observation of patients with FNH is required because its natural course is unknown and these lesions can bleed or rupture.

摘要

目的

尽管诊断成像技术的最新进展使许多局灶性结节性增生（FNH）患者避免了手术治疗，但大的FNH的自然病程仍不清楚。

病例报告

一名25岁男性因1998年6月常规检查发现肝脏有一巨大肿块而入院。唯一的实验室异常是γ-谷氨酰转肽酶升高。计算机断层扫描、血管造影、使用F-18氟脱氧葡萄糖（FDG-PET）的正电子发射断层扫描以及使用锝-99m-半乳糖基新糖白蛋白（99mTc-NGA）的闪烁扫描显示血管呈辐轮状外观、肝细胞正常且无恶性病变。针吸活检的组织学结果与FNH一致。在获得知情同意后，患者同意进行观察。初始诊断两年后，他没有症状，计算机断层扫描显示病变的大小和特征没有变化。