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妊娠期间生长的炎性肝细胞腺瘤，类似于局灶性结节性增生，在分娩后其磁共振成像表现发生改变。

Inflammatory Hepatocellular Adenoma Mimicking Focal Nodular Hyperplasia That Grew during Pregnancy and Changed Its Appearance on Magnetic Resonance Imaging after Delivery.

机构信息

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Japan.

Department of Pathology, Faculty of Medicine, University of Miyazaki, Japan.

出版信息

Intern Med. 2023 Nov 1;62(21):3143-3149. doi: 10.2169/internalmedicine.0967-22. Epub 2023 Apr 7.

DOI:10.2169/internalmedicine.0967-22
PMID:37032077
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10686732/
Abstract

We reported a notable case of inflammatory hepatocellular adenoma that grew during pregnancy, consequently changing its appearance on magnetic resonance imaging remarkably. A 5-months-pregnant 35-year-old woman presented with a 37-mm liver nodule that had been diagnosed as focal nodular hyperplasia 3 years earlier. She had never used oral contraceptives. After 2 months, the nodule grew to 57 mm. The patient delivered a full-term infant without complications. Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging performed after delivery revealed markedly different findings compared with the first images. A liver biopsy was performed, and the tumor was diagnosed as inflammatory hepatocellular adenoma.

摘要

我们报告了一例妊娠期间生长的炎症性肝细胞腺瘤的显著病例，其磁共振成像表现显著改变。一位 35 岁的 5 个月孕妇，3 年前曾被诊断为局灶性结节性增生，出现一个 37mm 的肝脏结节。她从未服用过口服避孕药。2 个月后，结节长到 57mm。患者顺利分娩，无并发症。分娩后行钆喷替酸葡甲胺增强磁共振成像，与首次图像相比，发现明显不同的结果。行肝活检，诊断为炎症性肝细胞腺瘤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c79/10686732/f616911b4c88/1349-7235-62-3143-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c79/10686732/f34d131bcd5c/1349-7235-62-3143-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c79/10686732/85c8b165cac9/1349-7235-62-3143-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c79/10686732/f616911b4c88/1349-7235-62-3143-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c79/10686732/f34d131bcd5c/1349-7235-62-3143-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c79/10686732/85c8b165cac9/1349-7235-62-3143-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c79/10686732/f616911b4c88/1349-7235-62-3143-g003.jpg

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本文引用的文献

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Hepatocellular adenoma: Where are we now?肝细胞腺瘤：我们现在在哪里？
World J Gastroenterol. 2022 Apr 14;28(14):1384-1393. doi: 10.3748/wjg.v28.i14.1384.
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Hepatocellular adenoma: what we know, what we do not know, and why it matters.肝细胞腺瘤：我们所知、所不知，以及为何这很重要。
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Diagnostic value of morphological enhancement patterns in the hepatobiliary phase of gadoxetic acid-enhanced MRI to distinguish focal nodular hyperplasia from hepatocellular adenoma.
钆塞酸增强 MRI 肝胆期形态增强模式对鉴别局灶性结节增生与肝细胞腺瘤的诊断价值。
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Behavior and complications of hepatocellular adenoma during pregnancy and puerperium: a retrospective study and systematic review.妊娠期和产褥期肝细胞腺瘤的行为和并发症：回顾性研究和系统评价。
HPB (Oxford). 2021 Aug;23(8):1152-1163. doi: 10.1016/j.hpb.2021.04.019. Epub 2021 Apr 28.
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Hepatocellular adenoma, approximately half and predominantly inflammatory subtype, in 38 Japanese patients with several differences in age, gender, and clinical background factors from Western populations.38名日本患者患有肝细胞腺瘤，其中约一半为主要是炎症亚型，在年龄、性别和临床背景因素方面与西方人群存在一些差异。
Hepatol Res. 2021 Mar;51(3):336-342. doi: 10.1111/hepr.13613. Epub 2021 Feb 22.
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Guidelines and Good Clinical Practice Recommendations for Contrast Enhanced Ultrasound (CEUS) in the Liver - Update 2020 - WFUMB in Cooperation with EFSUMB, AFSUMB, AIUM, and FLAUS.肝脏对比增强超声（CEUS）临床实践指南和良好规范推荐 - 2020 年更新版 - WFUMB 联合 EFSUMB、AFSUMB、AIUM 和 FLAUS 制定。
Ultraschall Med. 2020 Oct;41(5):562-585. doi: 10.1055/a-1177-0530. Epub 2020 Jul 24.
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Unclassified hepatocellular adenoma with histological brown pigment deposition and serum PIVKA-II level elevation: a case report.伴有组织学棕色色素沉着及血清异常凝血酶原水平升高的未分类肝细胞腺瘤：一例报告
Surg Case Rep. 2020 May 7;6(1):94. doi: 10.1186/s40792-020-00853-6.
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J Hepatol. 2020 Jan;72(1):119-124. doi: 10.1016/j.jhep.2019.09.011. Epub 2019 Sep 21.
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