Choi B I, Takayasu K, Han M C
Department of Radiology, Seoul National University, College of Medicine, Korea.
AJR Am J Roentgenol. 1993 Jun;160(6):1177-87. doi: 10.2214/ajr.160.6.8388618.
Hepatocellular carcinomas frequently occur in association with liver cirrhosis, as chronic liver disease is one of the most important factors in carcinogenesis. In addition to small hepatocellular carcinomas (less than 3 cm in diameter), recent reports of pathologic studies of resected specimens from cirrhotic liver describe associated small nodular lesions (i.e., regenerating nodule, adenomatous hyperplasia, and early hepatocellular carcinoma). In hepatocarcinogenesis of the cirrhotic liver, a regenerating nodule might be the first step in the development of hepatocellular carcinoma, going through phases of adenomatous hyperplasia and early hepatocellular carcinoma in a multistep fashion. We describe the pathologic characteristics of small hepatocellular carcinomas and associated nodular hepatic lesions and review the current concepts of the role of these associated lesions in carcinogenesis. We also discuss the imaging findings of these abnormalities, the efficacy of various imaging techniques for diagnosing them, and the importance of imaging in treatment planning.
肝细胞癌常与肝硬化相关，因为慢性肝病是致癌作用中最重要的因素之一。除了小肝细胞癌（直径小于3厘米）外，近期有关肝硬化肝脏切除标本的病理研究报告描述了相关的小结节性病变（即再生结节、腺瘤样增生和早期肝细胞癌）。在肝硬化肝脏的肝癌发生过程中，再生结节可能是肝细胞癌发展的第一步，以多步骤方式经历腺瘤样增生和早期肝细胞癌阶段。我们描述了小肝细胞癌及相关肝结节性病变的病理特征，并综述了这些相关病变在致癌作用中的作用的当前概念。我们还讨论了这些异常的影像学表现、各种影像学技术对其诊断的效能以及影像学在治疗规划中的重要性。
