小儿巨大肝脏局灶性结节性增生1例报告

陈诚; 王俊杰; 吴涯昆

doi:10.3969/j.issn.1001-5256.2022.06.029

小儿巨大肝脏局灶性结节性增生1例报告

DOI: 10.3969/j.issn.1001-5256.2022.06.029

陈诚^{1, 2},
王俊杰^{1, 2},
吴涯昆^{1, 2, , ,}

1.
遵义医科大学研究生院，贵州遵义 563000
2.
遂宁市中心医院肝胆外科，四川遂宁 629000

基金项目:

四川省科技厅重点项目 (2019YJ0704);

四川省卫生和计划生育委员会科研重点项目 (17ZD020)

伦理学声明：本例报告已获得患者知情同意。

利益冲突声明：所有作者均声明不存在利益冲突。

作者贡献声明：陈诚负责课题设计，资料分析，撰写论文；王俊杰参与收集数据，修改论文；吴涯昆负责拟定写作思路，指导撰写文章并最后定稿。

详细信息

通信作者:
吴涯昆，353827514@qq.com

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- 被引次数: 0
出版历程
- 收稿日期: 2021-09-16
- 录用日期: 2021-10-29
- 出版日期: 2022-06-20

Giant focal nodular hyperplasia of the liver in children: A case report

Cheng CHEN^{1, 2},
Junjie WANG^{1, 2},
Yakun WU^{1, 2
, ,
,}

1.
Graduate School of Zunyi Medical University, Zunyi, Guizhou 563000, China
2.
Department of Hepatobiliary Surgery, Suining Central Hospital, Suining, Sichuan 629000, China

More Information

Corresponding author: WU Yakun, 353827514@qq.com(ORCID: 0000-0003-1342-3953)

摘要

- 局限性结节状增生 /
- 肝疾病 /
- 儿童
- Focal Nodular Hyperplasia /
- Liver Diseases /
- Child

HTML全文

图 1 腹部超声

Figure 1. Abdominal ultrasound

下载: 全尺寸图片幻灯片

图 2 腹部增强CT

注：a，增强扫描动脉期轴位示肝左叶肿块明显强化；b，增强扫描门脉期冠状位示门静脉左支受压、狭窄并肿块内见多发迂曲血管影。

Figure 2. Enhanced CT of the abdome

下载: 全尺寸图片幻灯片

图 3 腹部增强MRI

注：a，T₁WI肝左叶肿块呈中等信号；b，T₂WI呈稍高信号，其内见多发低信号条状分隔；c，增强扫描动脉期呈明显强化。

Figure 3. Contrast-enhanced MRI of the abdomen

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图 4 肝穿刺活检(HE染色，×100)

Figure 4. The microscopic image of liver biopsy (HE staining, ×100)

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图 5 术中肿块情况

注：a，肿块周围血管、胆管迂曲扩张; b，肿块表面不光整，呈结节样。

Figure 5. The intraoperative images of the mass

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图 6 术后病理(HE染色，×100)

Figure 6. The postoperative pathology (HE staining, ×100)

下载: 全尺寸图片幻灯片

参考文献(20)

[1]	MAILLETTE de BUY WENNIGER L, TERPSTRA V, BEUERS U. Focal nodular hyperplasia and hepatic adenoma: Epidemiology and pathology[J]. Dig Surg, 2010, 27(1): 24-31. DOI: 10.1159/000268404.
[2]	MARRERO JA, AHN J, RAJENDER REDDY K, et al. ACG clinical guideline: The diagnosis and management of focal liver lesions[J]. Am J Gastroenterol, 2014, 109(9): 1328-1347; quiz 1348. DOI: 10.1038/ajg.2014.213.
[3]	MYERS L, AHN J. Focal Nodular hyperplasia and hepatic adenoma: evaluation and management[J]. Clin Liver Dis, 2020, 24(3): 389-403. DOI: 10.1016/j.cld.2020.04.013.
[4]	CRISTIANO A, DIETRICH A, SPINA JC, et al. Focal nodular hyperplasia and hepatic adenoma: Current diagnosis and management[J]. Updates Surg, 2014, 66(1): 9-21. DOI: 10.1007/s13304-013-0222-3.
[5]	ZHANG G, WANG M, DUAN F, et al. Transarterial embolization with bleomycin for symptomatic hepatic focal nodular hyperplasia[J]. Diagn Interv Radiol, 2017, 23(1): 66-70. DOI: 10.5152/dir.2016.16061.
[6]	GE L, ZHAN JH. Progress in etiology, diagnosis and treatment of focal nodular hyperplasia of liver in children[J]. J China Pediatr Blood Cancer, 2018, 23(1): 49-52. DOI: 10.3969/j.issn.1673-5323.2018.01.012. 葛亮, 詹江华. 儿童肝脏局灶性结节性增生的病因机制及诊治进展[J]. 中国小儿血液与肿瘤杂志, 2018, 23(1): 49-52. DOI: 10.3969/j.issn.1673-5323.2018.01.012.
[7]	CHEN Y, ZHOU B, SHEN YL, et al. Multi-slice spiral CT and MRI findings and pathological basis of hepatic focal nodular hyperplasia[J]. J Chin Pract Diagn Ther, 2017, 31(12): 1217-1219. DOI: 10.13507/j.issn.1674-3474.2017.12.021. 陈燕, 周碧, 申玉兰, 等. 肝脏局灶性结节增生的多层螺旋CT和MRI表现及病理基础[J]. 中华实用诊断与治疗杂志, 2017, 31(12): 1217-1219. DOI: 10.13507/j.issn.1674-3474.2017.12.021.
[8]	ZHANG Y, DING H. Lmaging study and clinical progress of focal nodular hyperplasia of liver[J/CD]. Chin J Med Ultrasound(Electronic Edition), 2016, 13(4): 245-248. DOI: 10.3877/cma.j.issn.1672-6448.2016.04.002. 张悦, 丁红. 肝脏局灶性结节性增生的影像学研究及临床新进展[J/CD]. 中华医学超声杂志(电子版), 2016, 13(4): 245-248. DOI: 10.3877/cma.j.issn.1672-6448.2016.04.002.
[9]	GIAMBELLUCA D, TAIBBI A, MIDIRI M, et al. The "spoke wheel" sign in hepatic focal nodular hyperplasia[J]. Abdom Radiol (NY), 2019, 44(3): 1183-1184. DOI: 10.1007/s00261-018-1852-1.
[10]	WANG W, QIE YY, FU CW. Clinical analysis of liver cancer misdiagnosed as focal nodular hyperplasia of the liver[J]. Clin Misdiagn Misther, 2020, 33(4): 18-20. DOI: 10.3969/j.issn.1002-3429.2020.04.005. 王伟, 郄言言, 付彩文. 肝癌误诊为肝脏局灶结节性增生临床分析[J]. 临床误诊误治, 2020, 33(4): 18-20. DOI: 10.3969/j.issn.1002-3429.2020.04.005.
[11]	WANG W, CHEN LD, LU MD, et al. Contrast-enhanced ultrasound features of histologically proven focal nodular hyperplasia: Diagnostic performance compared with contrast-enhanced CT[J]. Eur Radiol, 2013, 23(9): 2546-2554. DOI: 10.1007/s00330-013-2849-3.
[12]	YANG XW. Differential value of 64 slice spiral CT in liver carcinoma and focal nodular hyperplasia[J]. Mod J Integr Tradit Chin West Med, 2016, 25(12): 1344-1345, 1350. DOI: 10.3969/j.issn.1008-8849.2016.12.033. 杨秀文. 64层螺旋CT对肝癌及肝脏局灶性结节增生的鉴别价值[J]. 现代中西医结合杂志, 2016, 25(12): 1344-1345, 1350. DOI: 10.3969/j.issn.1008-8849.2016.12.033.
[13]	WU J, JING ZL. Research advances in MRI features and diagnosis of hepatocellular adenomas[J]. J Clin Hepatol, 2016, 32(10): 2012-2015. DOI: 10.3969/j.issn.1001-5256.2016.10.045. 吴杰, 敬宗林. 各类肝腺瘤磁共振成像特征及诊断的研究进展[J]. 临床肝胆病杂志, 2016, 32(10): 2012-2015. DOI: 10.3969/j.issn.1001-5256.2016.10.045.
[14]	KHANNA M, RAMANATHAN S, FASIH N, et al. Current updates on the molecular genetics and magnetic resonance imaging of focal nodular hyperplasia and hepatocellular adenoma[J]. Insights Imaging, 2015, 6(3): 347-362. DOI: 10.1007/s13244-015-0399-8.
[15]	NAULT JC, BLANC JF, MOGA L, et al. Non-invasive diagnosis and follow-up of benign liver tumours[J]. Clin Res Hepatol Gastroenterol, 2022, 46(1): 101765. DOI: 10.1016/j.clinre.2021.101765.
[16]	ROWAN DJ, ALLENDE DS, BELLIZZI AM, et al. Diagnostic challenges of focal nodular hyperplasia: interobserver variability, accuracy, and the utility of glutamine synthetase immunohistochemistry[J]. Histopathology, 2021, 79(5): 791-800. DOI: 10.1111/his.14424.
[17]	SUN J, WANG J. Diagnosis and standardized management of hepatic focal nodular hyperplasia[J]. Chin J Pract Surg, 2013, 33(9): 742-745. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWK201309009.htm 孙健, 王捷. 肝脏局灶性结节性增生诊断及规范化治疗[J]. 中国实用外科杂志, 2013, 33(9): 742-745. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWK201309009.htm
[18]	RAMAI D, OFOSU A, LAI JK, et al. Fibrolamellar hepatocellular carcinoma: A population-based observational study[J]. Dig Dis Sci, 2021, 66(1): 308-314. DOI: 10.1007/s10620-020-06135-3.
[19]	YAO Z, ZENG Q, YU X, et al. Case report: Ultrasound-guided percutaneous microwave ablation of focal nodular hyperplasia in a 9-year-old girl[J]. Front Pediatr, 2021, 9: 710779. DOI: 10.3389/fped.2021.710779.
[20]	PERRAKIS A, DEMIR R, MVLLER V, et al. Management of the focal nodular hyperplasia of the liver: Evaluation of the surgical treatment comparing with observation only[J]. Am J Surg, 2012, 204(5): 689-696. DOI: 10.1016/j.amjsurg.2012.02.006.