肝脏局灶结节性增生238例临床病理分析  

Focal nodular hyperplasia of liver： a clinlcopathologic study of 238 patients

作　　者：陈伶俐[1] 纪元[1] 许建芳[1] 卢韶华[1] 侯英勇[1] 侯君[1] 宿杰·阿克苏[1] 曾海英[1] 谭云山[1] 

机构地区：[1]复旦大学附属中山医院病理科,上海200032

出　　处：《中华病理学杂志》2011年第1期17-22,共6页Chinese Journal of Pathology

摘　　要：目的 分析肝脏局灶结节性增生（FNH）的临床病理特点.方法 回顾性分析238例FNH患者的临床及影像资料,复习大体标本及光镜下组织学特点,按照现有的分类标准对FNH行组织学分类,并对所有患者随访.结果 238例FNH患者中男性145例,女性93例,年龄11～77岁,平均年龄39.1岁.有完整临床资料的233例中,188例无相关症状,216例无乙型和（或）丙型病毒性肝炎史,232例患者血清甲胎蛋白为阴性.有影像结果的185例中123例（66.5%）经影像诊断为FNH.大体观察上238例FNH标本包含284枚病灶,平均直径3.7cm,215例（90.3%）单发,172枚发生于肝右叶,115枚（40.5%）切面可见星状瘢痕或呈结节状.光镜下观察238枚FNH病灶,229枚（96.2%）为经典型FNH,6枚为毛细血管扩张型FNH,3枚为混合性增生与腺瘤样型FNH,未见到细胞不典型FNH.173例患者获得随访结果,无FNH相关性死亡,2例患者于术后2年和4年复发.结论 FNH是对肝脏内局部异常血流的反应性肝细胞增生性疾病,无女性好发倾向;毛细血管扩张型FNH应归类为肝细胞腺瘤,该组无细胞不典型FNH;超过66%的病例可经影像诊断.Objective To study the clinicopathologic features of focal nodular hyperplasia （FNH）of liver. Methods The clinical, radiologic, pathologic findings and follow-up data of 238 cases of FNH were retrospectively analyzed. Results The patients included 93 females and 145 males. The age of the patients ranged from 11 to 77 years（median=39.1 years）. Amongst the 233 patients who had clinical information available, 188 were asymptomatic, 216 had no history of hepatitis B and/or C infection and 232had negative serum alpha-fetoprotein level. Amongst the 185 patients who had undergone radiologic examination, 123（66.5%） were accurately diagnosed as such. Macroscopically, of the 284 lesions from 238 patients, the average diameter was 3.7cm. Two hundred and fifteen cases （90.3%） were solitary, 172cases were located in the right lobe and 115（40.5%） had central stellate fibrotic scars or lobulated cut surface. Histologically, 229 lesions belonged to classic type and 9 lesions were of non-classic type. The latter was further classified as the telangiectatic form （6 lesions ） and the mixed hyperplastic and adenomatous form（3 lesions）. There was no evidence of significant cytologic atypia. Follow-up data were available in 173 patients （72.7%）.None of them died of the disease and 2 patients suffered from relapses after 2 and 4 years, respectively. Conclusions FNH is a hyperplastic response of normal liver cells to local blood flow anomalies. It has no obvious sex predilection and more than 66% can be diagnosed accurately with radiologic examination. The lesions in the current study show no cytologic atypia.

关 键 词：肝脏疾病 增生 诊断 

分 类 号：R735.7[医药卫生—肿瘤]