Lubbers P R, Ros P R, Goodman Z D, Ishak K G
AJR Am J Roentgenol. 1987 Jun;148(6):1105-8. doi: 10.2214/ajr.148.6.1105.
It is currently believed that hepatocellular adenoma is photon deficient on technetium-99m sulfur colloid scintigraphy because these tumors lack Kupffer cells. In a retrospective review of 13 pathologically proven cases of hepatocellular adenoma with technetium-99m sulfur colloid scintigrams, Kupffer cells were present in all 13 cases. We observed uptake of the radiocolloid by the hepatocellular adenoma in three cases (23%), and there were no histologic differences between the tumors with uptake and the ones without it. We conclude that the currently accepted reason for the lack of technetium-99m sulfur colloid uptake within hepatocellular adenoma is incorrect, and an explanation other than a lack of Kupffer cells is responsible for the photon-deficient appearance in the majority of cases of hepatocellular adenoma. Further, because hepatocellular adenoma may have technetium-99m sulfur colloid uptake in a significant percentage of cases, it should be added to focal nodular hyperplasia in the differential diagnosis of a hepatic mass with uptake by technetium-99m sulfur colloid.
目前认为，肝细胞腺瘤在99m锝硫胶体闪烁扫描中表现为光子缺乏，因为这些肿瘤缺乏库普弗细胞。在一项对13例经病理证实的肝细胞腺瘤病例及99m锝硫胶体闪烁扫描图的回顾性研究中，所有13例均存在库普弗细胞。我们观察到3例（23%）肝细胞腺瘤摄取了放射性胶体，摄取与未摄取放射性胶体的肿瘤之间无组织学差异。我们得出结论，目前关于肝细胞腺瘤缺乏99m锝硫胶体摄取的公认原因是错误的，在大多数肝细胞腺瘤病例中，除缺乏库普弗细胞外的其他原因导致了光子缺乏表现。此外，由于相当比例的肝细胞腺瘤病例可能摄取99m锝硫胶体，在鉴别诊断摄取99m锝硫胶体的肝脏肿块时，应将其加入局灶性结节性增生的鉴别诊断中。
