Gainey Christina S, Palmer Suzanne L, Mena Edward, Kaur Navpreet, Gong Yuna, Kahn Jeffrey A
Department of Internal Medicine, LAC+USC Medical Center, Keck School of Medicine of USC, USA.
Department of Radiology, Keck School of Medicine of USC, USA.
Case Rep Transplant. 2020 Oct 2;2020:8824099. doi: 10.1155/2020/8824099. eCollection 2020.
Following liver transplantation (LT), recipients can develop benign and malignant hepatic masses just like any other patient. Patients transplanted for hepatocellular carcinoma (HCC) undergo surveillance imaging, and any new mass seen on imaging must be carefully evaluated to rule out recurrent cancer. Focal nodular hyperplasia (FNH) is a benign tumor of the liver that most often occurs in women and is rarely symptomatic. It is important to distinguish FNH from more serious etiologies, such as recurrent HCC and other malignancies, since the treatments differ greatly. To date, there have been very few reports of FNH occurring in a liver allograft. We present a case of a patient with a history of a carcinoid tumor who underwent LT for HCC. Several years posttransplant, the patient was found to have a liver mass with classic features of HCC on imaging. The liver biopsy revealed the unexpected diagnosis of FNH. This finding avoided unnecessary treatment for HCC, which is associated with morbidity, especially in the posttransplant setting. We present our diagnostic approach, discuss the clinicopathologic and imaging findings of FNH, and review the literature on FNH in the posttransplant setting.
肝移植（LT）后，受者会像其他患者一样出现良性和恶性肝脏肿块。因肝细胞癌（HCC）接受移植的患者需进行监测成像，成像中发现的任何新肿块都必须仔细评估以排除复发性癌症。局灶性结节性增生（FNH）是一种肝脏良性肿瘤，最常见于女性，很少有症状。将FNH与更严重的病因（如复发性HCC和其他恶性肿瘤）区分开来很重要，因为治疗方法差异很大。迄今为止，关于肝移植受者发生FNH的报道非常少。我们报告一例有类癌病史的患者，因HCC接受了LT。移植后数年，该患者在成像中发现肝脏肿块，具有HCC的典型特征。肝脏活检显示意外诊断为FNH。这一发现避免了对HCC进行不必要的治疗，HCC治疗会带来并发症，尤其是在移植后。我们介绍了我们的诊断方法，讨论了FNH的临床病理和成像表现，并回顾了移植后FNH的相关文献。
