Miry Nadir, Najioui Younesse, Haloui Anass, Karich Nassira, Bennani Amal
Department of Pathology, Faculty of Medicine and Pharmacy, Oujda, MAR.
Cureus. 2024 Jan 23;16(1):e52835. doi: 10.7759/cureus.52835. eCollection 2024 Jan.
Solitary necrotic nodule (SNN) of the liver is an uncommon and benign finding in liver pathology. Typically, it appears as a single and asymptomatic lesion, primarily located at the subcapsular region of the right lobe of the liver. Unfortunately, it is easy to mistake this benign lesion for a primary or secondary neoplastic lesion, making it a potential diagnosis pitfall for liver malignancies. The diagnosis of SNN can be difficult to determine as the imaging findings frequently lack specificity. This brings out the importance of histomorphological examination to accurately identify this lesion, and to rule out any possible malignancies. We report here the case of a 35-year-old woman with a history of squamous cell carcinoma of the cervix, who presented a solitary nodule on her liver that was falsely diagnosed as a metastatic lesion in the liver at imagery. The aim of this article is to highlight the importance of using special stains and immunohistochemical staining for diagnosing SNN and excluding any necrotic metastases of the liver. We demonstrated that the absence of a reticulin meshwork in the necrotic core should prompt consideration of a necrotic metastasis in the liver, rather than a solitary necrotic nodule.
肝脏孤立性坏死结节（SNN）在肝脏病理学中是一种罕见的良性病变。通常，它表现为单个无症状性病灶，主要位于肝右叶的包膜下区域。不幸的是，这种良性病变很容易被误诊为原发性或继发性肿瘤性病变，这使其成为肝脏恶性肿瘤潜在的诊断陷阱。由于影像学表现常常缺乏特异性，SNN的诊断可能难以确定。这凸显了组织形态学检查对于准确识别该病变并排除任何可能的恶性肿瘤的重要性。我们在此报告一例35岁有子宫颈鳞状细胞癌病史的女性病例，其肝脏出现一个孤立结节，在影像学检查中被误诊为肝脏转移性病变。本文的目的是强调使用特殊染色和免疫组化染色诊断SNN以及排除肝脏任何坏死性转移灶的重要性。我们证明，坏死核心中无网状纤维网络应促使考虑肝脏坏死性转移，而非孤立性坏死结节。
