Ohmoto Kenji, Honda Toshihiro, Hirokawa Mitsuyoshi, Mitsui Yasuhiro, Iguchi Yasutaka, Kuboki Makoto, Yamamoto Shinichiro
Division of Gastroenterology, Department of Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan.
J Gastroenterol. 2002;37(10):849-53. doi: 10.1007/s005350200140.
Focal nodular hyperplasia (FNH) of the liver is a rare benign lesion that probably reflects a local hyperplastic response of hepatocytes to a vascular abnormality. Currently, the natural history of the disease remains largely unknown. We present a patient with FNH of the liver who was followed up for 4 years. A 22-year-old woman with a 3-year history of oral contraceptive use was referred to our hospital in September 1996 for further examination of a liver tumor. A diagnosis of FNH was made using various imaging methods, such as ultrasonography, enhanced computed tomography (CT) scanning, MR imaging, and hepatic angiography, as well as fine-needle biopsy. A decrease in the size of the lesion was observed by enhanced CT scanning during the 4-year observation period. In this patient, oral contraceptive use and its discontinuation may have influenced the natural history of FNH. The present case suggests that an accurate diagnosis is of the utmost importance, and a patient with FNH should be managed conservatively rather than by resection, because FNH has the potential for spontaneous regression with the discontinuation of oral contraceptives.
肝脏局灶性结节性增生(FNH)是一种罕见的良性病变,可能反映了肝细胞对血管异常的局部增生反应。目前,该病的自然病程在很大程度上仍不清楚。我们报告一例肝脏FNH患者,对其进行了4年的随访。一名有3年口服避孕药史的22岁女性于1996年9月转诊至我院,以进一步检查肝脏肿瘤。通过超声、增强计算机断层扫描(CT)、磁共振成像(MR)、肝血管造影以及细针穿刺活检等多种影像学方法确诊为FNH。在4年的观察期内,增强CT扫描显示病变大小有所减小。在该患者中,口服避孕药及其停用可能影响了FNH的自然病程。本病例提示准确的诊断至关重要,FNH患者应采取保守治疗而非手术切除,因为停用口服避孕药后FNH有自发消退的可能。