Evans J E, Dick R, Sherlock S
Br J Surg. 1980 Mar;67(3):175-7. doi: 10.1002/bjs.1800670305.
Focal nodular hyperplasia of the liver (FNH) in a fit young Iranian girl of 19 months presented with asymptomatic hepatomegaly. Liver scan and ultrasound examinations demonstrated a space-occupying lesion involving both hepatic lobes. Arteriography revealed a vascular pattern suggestive of liver cell carcinoma with dilated arterial branches and tumour blush on the capillary phase. At laparotomy the large mass involved both right and left hepatic lobes and was not resected. Tissue diagnosis was established by surgical wedge biopsy. FNH should be considered in the differential diagnosis of an hepatic mass in a clinically well child, particularly female, in which the liver biopsy suggests cirrhosis but arteriography favours liver cell carcinoma. If FNH is diagnosed and the lesion is not resected it is recommended that patients be advised against sex hormone therapy as there may be an increased risk of rupture with intraperitoneal haemorrhage.
一名19个月大、身体健康的伊朗年轻女孩患肝脏局灶性结节性增生（FNH），表现为无症状性肝肿大。肝脏扫描和超声检查显示一个占据双侧肝叶的占位性病变。动脉造影显示血管形态提示肝细胞癌，动脉分支扩张，毛细血管期有肿瘤染色。剖腹手术时，巨大肿块累及左右肝叶，未予切除。通过手术楔形活检确立了组织诊断。对于临床上健康儿童（尤其是女性）肝脏肿块的鉴别诊断，应考虑FNH，其中肝脏活检提示肝硬化，但动脉造影支持肝细胞癌。如果诊断为FNH且病变未切除，建议告知患者避免接受性激素治疗，因为破裂并发生腹腔内出血的风险可能会增加。
