Putra Juan, Toor Arifa, Noce Todd A, Thung Swan N, Suriawinata Arief A, Lisovsky Mikhail
Department of Pathology Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
Department of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
Ann Hepatol. 2015 Jul-Aug;14(4):547-9.
Focal nodular hyperplasia and nodular regenerative hyperplasia are occasionally seen in patients with hepatic venous outflow obstruction as a consequence of circulatory stress in the liver. In addition, neoplastic processes such as hepatic adenoma, hepatocellular carcinoma, and metastatic disease may arise in these patients. Histologic evaluation is necessary when imaging modalities are unable to distinguish these lesions. We present a case of multiple hepatic lesions, suspicious for metastases, in a patient with Budd-Chiari syndrome secondary to polycythemia vera. However, the biopsy findings were consistent with focal nodular hyperplasia. Budd-Chiari syndrome may be associated with multiple nodules of focal nodular hyperplasia, which may be difficult to diagnose radiologically.
肝静脉流出道梗阻患者由于肝脏循环压力，偶尔会出现局灶性结节性增生和结节性再生性增生。此外，这些患者可能会发生肝腺瘤、肝细胞癌和转移性疾病等肿瘤性病变。当影像学检查无法区分这些病变时，组织学评估是必要的。我们报告一例真性红细胞增多症继发布加综合征患者出现多个可疑转移的肝脏病变。然而，活检结果与局灶性结节性增生一致。布加综合征可能与多个局灶性结节性增生结节相关，这在放射学上可能难以诊断。
