肝局灶性结节状增生的临床病理学观察  

Clinicopathologic analysis of 36 cases of focal nodular hyperplasia of the liver

作　　者：钟梅[1] 毛永平[1] 李冰[1] 朱凤伟[1] 于国[1] 

机构地区：[1]解放军总医院病理科,北京100853

出　　处：《解放军医学杂志》2011年第9期948-950,共3页Medical Journal of Chinese People's Liberation Army

摘　　要：目的观察肝局灶性结节状增生（FNH）的临床及病理学特点。方法收集解放军总医院1989年2月-2010年10月手术切除的FNH标本36例,均经4%甲醛溶液固定,石蜡包埋切片,行HE染色及CD34、CK免疫组化染色（SP法）,光镜下观察其组织病理形态。结果 36例患者中男10例,女26例,平均年龄36.1岁;34例呈单发结节,2例呈多发结节;结节直径1.7~20.0cm,平均6.8cm;临床及影像学缺少特异性表现。组织形态学观察显示36例FNH中6例为血管扩张型,25例为经典型,3例为混合型,2例为肝细胞不典型增生型。病理学表现为结节状肿块,中央为纤维性瘢痕,其内为大小不等厚壁血管。免疫组化染色CD34及CK均呈阳性。经典型FNH具有4种特征性形态学表现,即肿瘤结节中央有星状瘢痕、异常结节状结构、畸形血管和毛细胆管增生。结论 FNH的病因可能与病灶处局部血液循环障碍有关。Objective To study the clinical and pathologic features of focal nodular hyperplasia（FNH） of the liver.Methods Thirty-six surgical specimens of FNH collected from February 1989 to October 2010 in the General Hospital of PLA were used in the present study.The 36 formalin-fixed,paraffin-embedded surgical resection specimens were analyzed by hematoxylin-eosin（H-E）-staining and immunohistochemistry for CD34 and CK.The pathological changes were observed under light microscope.Results Of the 36 cases,10 were males and 26 were females,with an average age of 36.1 years.A single nodule was found in 34 cases and multiple nodules were found in 2 cases.The diameters of the nodules ranged from 1.7 to 20cm,with an average of 6.8cm,and with no specific clinical and radiological manifestations.The histomorphological examination revealed that there were 6 cases of telangiectatic type,25 of classic type,3 of mixed type,and 2 of hepatic cell dysplastic type.The pathological features of the lesions were nodular mass with central fibrous scars containing thick-wall vessels.All the specimens were positive for CD34 and CK immunohistochemical staining.The classical form of FNH was defined by the presence of four characteristic histological features： nodular central satellite scar,abnormal nodular structures,malformed vessels,and cholangiolar proliferation.Conclusion Local circulatory disturbances may be related to the occurrence of FNH.

关 键 词：局限性结节状增生 病理学 临床 

分 类 号：R730.2[医药卫生—肿瘤]