Minato H, Nakanuma Y, Kawada N
Second Department of Pathology, Kanazawa University School of Medicine, Japan.
Acta Pathol Jpn. 1991 Dec;41(12):911-5. doi: 10.1111/j.1440-1827.1991.tb01638.x.
Adenomatous hyperplasia of the liver is known as a preneoplastic or early developmental stage of hepatocellular carcinoma, in which overt malignant foci occasionally develop. We have recently experienced an autopsy case (a 70-year-old male) of liver cirrhosis with hepatocellular carcinoma and two nodules of adenomatous hyperplasia. The latter two nodules contained several microscopic foci of moderately differentiated hepatocellular carcinoma. There were a number of tumor microemboli in portal vein branches within areas of adenomatous hyperplasia in addition to areas surrounding cirrhotic liver, some of which grew into the parenchyma of adenomatous hyperplasia and cirrhotic regenerative nodules. These findings and the fact that adenomatous hyperplasia contained portal tracts including portal venous branches, suggest that malignant foci in adenomatous hyperplasia contained portal tracts including represent metastases from hepatocellular carcinoma in other parts of the liver via the intrahepatic portal venous system.
肝脏腺瘤样增生被认为是肝细胞癌的癌前或早期发育阶段,在此阶段偶尔会出现明显的恶性病灶。我们最近遇到一例尸检病例(一名70岁男性),患有肝硬化伴肝细胞癌以及两个腺瘤样增生结节。后两个结节包含多个中分化肝细胞癌的微小病灶。除了肝硬化肝脏周围区域外,在腺瘤样增生区域的门静脉分支中有许多肿瘤微栓子,其中一些生长到腺瘤样增生的实质和肝硬化再生结节中。这些发现以及腺瘤样增生包含包括门静脉分支在内的门管区这一事实表明,腺瘤样增生中的恶性病灶包含门管区,代表通过肝内门静脉系统来自肝脏其他部位肝细胞癌的转移灶。