Adenomatous hyperplasia of the liver resembling focal nodular hyperplasia in patients with chronic liver disease
Adenomatous hyperplasia of the liver resembling focal nodular hyperplasia in patients with chronic liver disease
复制标题
慢性肝病患者的肝脏腺瘤性增生类似局灶性结节性增生
DOI：
10.1007/bf01621809
复制
发表时间：
2005
期刊：
影响因子：
--
通讯作者：
S. Masuda
中科院分区：
文献类型：
--
作者：
T. Terada;Satoru Kitani;K. Ueda;Y. Nakanuma;K. Kitagawa;S. Masuda
在两名肝硬化或慢性活动性肝炎患者中发现两个类似局灶性结节性增生的肝腺瘤性增生（AH）结节。影像学技术提示结节是肝细胞癌。病理检查显示，结节直径约1.0 cm，与周围肝组织界限清楚，结节中心有疤痕样纤维化灶。显微镜下，它们包含汇管束并满足 AH 的标准。中央的疤痕样纤维化以及结节的实质中存在大量动脉。一个结节中有轻度非典型肝细胞病灶，但另一结节中没有细胞异型性。形态计量学分析显示，结节内单位面积动脉累积管腔面积远大于结节外肝组织，而结节内单位面积门静脉累积管腔面积远小于结节外肝组织。尽管发病机制尚不清楚，但这些结节可能是通过与慢性肝病相关的局部血管变化而形成的，可能是由先前存在的动脉畸形引起的，或者可能代表肝癌发生中血管生成的早期阶段。
Two nodules of hepatic adenomatous hyperplasia (AH) resembling focal nodular hyperplasia were found in two patients with cirrhosis or chronic active hepatitis. Imaging techniques suggested that the nodules were hepatocellular carcinoma. Pathological examination showed that the nodules (approximately 1.0 cm in diameter) were clearly demarcated from the surrounding liver tissue, and contained foci of scar-like fibrosis in the centre of the nodules. Microscopically, they contained portal tracts and fulfilled the criteria of AH. A large number of arteries were present in the central scarlike fibrosis as well as in the parenchyma of the nodules. There were foci of mildly atypical hepatocytes in one nodule but no cellular atypia in the other. Morphometric analysis showed that the cumulative luminal area of arteries per unit area was much greater in the nodules than in the extranodular liver tissues, while the cumulative luminal area of portal veins per unit area was much less in the nodules than in the extranodular liver tissues. Although the pathogenesis is unclear, these nodules might have developed through localized vascular changes associated with chronic liver disease, may have arisen from pre-existing arterial malformation, or may represent the early stages of angiogenesis in hepatocarcinogenesis.