Lesch R, Hoppe-Seyler P, Heissmeyer H H, Hoensch D, Jenss H, Wimmer B, Wenz W
Radiologe. 1980 Dec;20(12):565-76.
Tumorous lesions of the liver were diagnosed by means of angiography, sonography and laparoscopy in six patients on oral contraceptives for a long time. These lesions were identified as liver cell adenoma (1), focal nodular hyperplasia (4) and cavernous hemangioma (1). The relationship between oral contraceptives and liver disorders is well-known. All cases of focal nodular hyperplasia show vascular alterations which may be important in the discussion of oral contraceptives being responsible. In contrast to liver cell adenoma and hemangioma, focal nodular hyperplasia may be considered as a nodular reparative regeneration of the parenchyma following focal parenchymal necrosis due to segmental vascular occlusion (i. e. thrombosis or fibrotic intimal obliteration). This lesions can therefore not be defined as a true neoplasm. The clinical findings are uncharacteristic, whereas selective hepatic artery angiography, shows typical features that distinguish liver cell adenoma from focal nodular hyperplasia. Regular medical examinations are recommended for women on continuous oral contraceptives for more than five years, because this group of patients is threatened by serious sequelae including intrahepatic and abdominal hemorrhage.
通过血管造影、超声检查和腹腔镜检查,确诊了6名长期服用口服避孕药的患者患有肝脏肿瘤性病变。这些病变被确定为肝细胞腺瘤(1例)、局灶性结节性增生(4例)和海绵状血管瘤(1例)。口服避孕药与肝脏疾病之间的关系是众所周知的。所有局灶性结节性增生病例均显示血管改变,这在讨论口服避孕药是否致病时可能很重要。与肝细胞腺瘤和血管瘤不同,局灶性结节性增生可被视为由于节段性血管闭塞(即血栓形成或纤维性内膜闭塞)导致局灶性实质坏死之后实质的结节性修复性再生。因此,这种病变不能被定义为真正的肿瘤。其临床表现无特征性,而选择性肝动脉造影显示出可将肝细胞腺瘤与局灶性结节性增生区分开来的典型特征。建议连续服用口服避孕药超过五年的女性定期进行体检,因为这组患者受到包括肝内和腹腔内出血在内的严重后遗症的威胁。