Paediatric Oncology and Haematology Unit Lalla Seràgnoli, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
J Pediatr Gastroenterol Nutr. 2013 Feb;56(2):151-5. doi: 10.1097/MPG.0b013e31826f7660.
Benign nodular hepatic regenerating lesions such as focal nodular hyperplasia (FNH) have been reported as rare complications of the antineoplastic therapy received during infancy. Little is known about the risk factors associated with the onset of these lesions and their diagnostic management.
We have analyzed a series of benign hepatic nodular lesions occurring in children previously treated for malignant tumors in our institution in a period of 11 years. An extensive description of the imaging presentation of the lesions has been provided to facilitate the differential diagnosis, and a risk factor analysis has been conducted.
A total of 14 diagnoses (10 FNH and 4 hemangiomas) of benign nodular hepatic lesions have been found. Hematopoietic stem cell transplantation is the most important statistically independent risk factor associated with the development of these lesions, especially for FNH. No malignant transformation of nodules has been recorded during a median follow-up time of 4 years.
In our experience, FNH is the most frequent benign nodular hepatic lesions occurring after treatment for childhood cancer. Hematopoietic stem cell transplantation is the most important risk factor to be taken in account. After a secure diagnosis of these benign lesions, only a close imaging follow-up is recommended.
良性结节性肝再生病变，如局灶性结节性增生（FNH），已被报道为婴儿期接受抗肿瘤治疗的罕见并发症。目前对于这些病变的发病风险因素及其诊断处理知之甚少。
我们分析了在本机构接受过恶性肿瘤治疗的儿童在 11 年期间发生的一系列良性肝结节性病变。对病变的影像学表现进行了详细描述，以方便鉴别诊断，并进行了风险因素分析。
共发现 14 例（10 例 FNH 和 4 例血管瘤）良性结节性肝病变的诊断。造血干细胞移植是与这些病变发展最相关的最重要的统计学独立风险因素，尤其是 FNH。在中位数为 4 年的随访期间，未记录到结节的恶性转化。
根据我们的经验，FNH 是儿童癌症治疗后最常见的良性肝结节性病变。造血干细胞移植是需要考虑的最重要的风险因素。在这些良性病变得到明确诊断后，仅建议进行密切的影像学随访。
