Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center Hospital, 1007 Shimo-Nagakubo, Sunto-Nagaizumi, Shizuoka, 411-8777, Japan.
Surg Today. 2012 Jan;42(2):200-4. doi: 10.1007/s00595-011-0067-7. Epub 2011 Dec 10.
We report a case of hepatocellular adenoma, focusing on the findings of liver-specific contrast agent-enhanced magnetic resonance imaging (MRI) and ¹⁸F-fluorodeoxyglucose positron emission tomography (FDG-PET). The patient was a 37-year-old woman, referred to us after contrast-enhanced computed tomography showed a homogeneous, poorly enhanced liver tumor, 2.8 cm in diameter. Magnetic resonance imaging showed a liver mass with significant fatty change. The tumor increased in size to 3.3 cm over 9 months of follow-up. Gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid-enhanced MRI revealed spotty enhancement in the hypointense tumor in the hepatobiliary phase. Subsequent FDG-PET showed increased uptake of FDG (maximum standardized uptake value 5.0), which suggested the possibility of malignancy. The patient underwent partial hepatectomy, and histological examination of the resected specimen revealed a tumor composed of hepatocyte-like cells with minimal cellular atypia and significant diffuse fatty change. Based on these findings, we diagnosed hepatocellular adenoma.
我们报告了 1 例肝细胞腺瘤病例,重点介绍了肝脏特异性对比剂增强磁共振成像(MRI)和 ¹⁸F-氟脱氧葡萄糖正电子发射断层扫描(FDG-PET)的结果。患者为 37 岁女性,因增强 CT 显示直径 2.8cm 的均匀、低增强肝肿瘤而转至我院。MRI 显示肝脏肿块伴有明显脂肪变性。肿瘤在 9 个月的随访中增大至 3.3cm。钆乙氧基苯甲基二乙撑三胺五乙酸增强 MRI 显示在肝胆期低信号肿瘤中有斑点状增强。随后的 FDG-PET 显示 FDG 摄取增加(最大标准化摄取值 5.0),提示可能为恶性肿瘤。患者接受了部分肝切除术,切除标本的组织学检查显示肿瘤由肝细胞样细胞组成,细胞异型性极小,弥漫性脂肪变性明显。基于这些发现,我们诊断为肝细胞腺瘤。