Hwang Nam Cheol, Choi Moon Seok, Lee Joon Hyoek, Koh Kwang Cheol, Paik Seung Woon, Yoo Byung Chul, Rhee Jong Chul, Lee Kwang-Woong, Joh Jae-Won, Park Cheol Keun
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Korean J Hepatol. 2004 Jun;10(2):135-41.
BACKGROUND/AIMS: Focal nodular hyperplasia (FNH) is a benign hepatic tumor with few serious complications and no malignant transformation. However, differential diagnosis between FNH and other liver tumors, especially hepatocellular carcinoma, is often difficult.
Clinical features of surgically resected FNH were reviewed. From January, 1995 to February, 2003, 10 patients with surgically resected FNH were enrolled. Their age, sex, results of laboratory examination, imaging studies and pathologic findings were evaluated.
Median age was 37.5 years and sex ratio (male:female) was 1.5:1. In 5 cases, resection to exclude hepatic adenoma or HCC was performed. Four cases were diagnosed incidentally after surgery. Four patients had risk factors for HCC, such as hepatitis B virus infection, liver cirrhosis or both. The size of FNH was 3.2 +/- 2.2 cm. The most common site of the tumor was segment 6 (30.0%). Differential diagnosis with HCC was difficult in 5 of six cases in whom CT was performed. Although needle biopsies were performed preoperatively in 4 cases, it was difficult to distinguish FNH from hepatic adenoma or HCC.
FNH was resected due to uncertainty of diagnosis, or incidentally during hepatectomy in patients with other liver disease. In the former, differential diagnosis with hepatic adenoma or HCC was a major problem despite extensive work-up including dynamic CT or biopsy.
背景/目的：局灶性结节性增生（FNH）是一种良性肝脏肿瘤，严重并发症少见，不会恶变。然而，FNH与其他肝脏肿瘤，尤其是肝细胞癌的鉴别诊断往往困难。
回顾性分析手术切除的FNH的临床特征。1995年1月至2003年2月，纳入10例手术切除FNH的患者。评估他们的年龄、性别、实验室检查结果、影像学检查和病理结果。
中位年龄为37.5岁，男女比例为1.5:1。5例患者为排除肝腺瘤或肝癌而进行切除手术。4例在术后偶然诊断。4例患者有肝癌危险因素，如乙肝病毒感染、肝硬化或两者兼有。FNH大小为3.2±2.2 cm。肿瘤最常见的部位是肝段6（30.0%）。6例行CT检查的病例中，5例难以与肝癌鉴别。尽管4例患者术前进行了穿刺活检，但难以将FNH与肝腺瘤或肝癌区分开来。
FNH因诊断不确定而被切除，或在其他肝脏疾病患者肝切除术中偶然发现。在前者中，尽管进行了包括动态CT或活检在内的广泛检查，但与肝腺瘤或肝癌的鉴别诊断仍是一个主要问题。
