Hsu Chuan-Yuan, Chu Cheng-Hsin, Lin Shee-Chan, Yang Fee-Shih, Yang Tsen-Long, Chang Kuo-Ming
Department of Hepatology and Gastroenterology, Mackay Memorial Hospital, No. 92, Chung-Shan N. Road 2 Section, 104 Chung-Shan Area, Taipei, Taiwan, China.
World J Gastroenterol. 2003 Mar;9(3):627-30. doi: 10.3748/wjg.v9.i3.627.
Hepatocelluar adenoma (HCA) and adenomatous hyperplasia (AH) are rare benign tumors of the liver. HCA is usually found in women who use oral contraceptives. AH usually occurs in patients with liver cirrhosis. Both tumors have potential for malignant transformation.
We described a male adult with chronic liver disease (CLD) who had been known to be a hepatitis B carrier (HBV) for years. He was found to have a space-occupying lesion with a suspicion of hepatocellular carcinoma (HCC) by abdominal ultrasonography. His alpha-fetoprotein (AFP) was normal. Angiographic findings were consistent with the diagnosis of HCC, he wished to avoid an operation, was treated with transcatheter hepatic arterial embolization.
He subsequently consented to surgery, and a right lobectomy was performed. The liver pathology disclosed HCA with nuclear dysplasia and post-embolization effects. In addition, there were multiple small foci of AH with nuclear dysplasia in the resected liver. Although he had some focal areas of cirrhosis-like change or post-embolization effect, the AH was associated only with normal liver tissue.
This case confirms that HCA and AH may resemble HCC on imaging studies, and that AH may occur in CLD in the absence of cirrhotic change.
肝细胞腺瘤（HCA）和腺瘤样增生（AH）是肝脏罕见的良性肿瘤。HCA通常在使用口服避孕药的女性中发现。AH通常发生在肝硬化患者中。这两种肿瘤都有恶变的可能。
我们描述了一名患有慢性肝病（CLD）的成年男性，他多年来一直是乙肝携带者（HBV）。通过腹部超声检查发现他有一个占位性病变，怀疑是肝细胞癌（HCC）。他的甲胎蛋白（AFP）正常。血管造影结果与HCC的诊断一致，他希望避免手术，接受了经导管肝动脉栓塞治疗。
他随后同意手术，进行了右叶切除术。肝脏病理显示为伴有核发育异常和栓塞后效应的HCA。此外，在切除的肝脏中有多个伴有核发育异常的AH小病灶。虽然他有一些局灶性肝硬化样改变或栓塞后效应，但AH仅与正常肝组织有关。
该病例证实，HCA和AH在影像学检查上可能类似于HCC，并且AH可能在无肝硬化改变的CLD中发生。
