アルコール性肝疾患を背景にしたfocal nodular hyperplasia-like noduleの一例

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  • A Case of Focal Nodular Hyperplasia-like Nodule in Alcoholic Liver Disease
  • アルコールセイ ギモ シッカン オ ハイケイ ニ シタ focal nodular hyperplasia-like nodule ノ イチレイ

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We report a case of 57-year-old Japanese man diagnosed as focal nodular hyperplasia-like nodule (FNHLN). He is a heavy drinker and has liver dysfunction. Seven years ago, he was taken to hospital because of traumatic accident. Enhanced computed tomography at the time of admission suggested hepatocellular carcinoma (HCC) in segment 6 (S6), without damage in the abdominal cavity. Angiography, CT during arterial portography (CTAP) and CT during hepatic arteriography (CTHA) were done. In the S6, angiography demonstrated hypervascularity nodular lesion in early phase and tumor stain in venous phase, but did not show a spoke-wheel pattern. CTAP showed portal defect image and CTHA showed enhanced effect. Since the lesion was preoperatively diagnosed as HCC, partial hepatectomy was performed. A nodular lesion measuring 3.5x2.3cm in size had incomplete capsule. Microscopically, the nodular lesion shows moderate increase of cell density and mildly irregular trabecular pattern, and shows scar-like fibrosis. There are marked iron deposits. The background liver shows cirrhosis like change. Therefore, the nodule was pathologically diagnosed as FNHLN. FNHLN is a rare disorder, which mimics focal nodular hyperplasia clinicopathologically. Benign hepatocellular lesions are increasingly diagnosed as a result of the advances in imaging studies. When a hypervascular lesion in liver is found, it is very important to keep this disease in mind.

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