資源描述：
《fnh肝局灶性結(jié)節(jié)性增生》由會(huì)員上傳分享，免費(fèi)在線閱讀，更多相關(guān)內(nèi)容在教育資源-天天文庫(kù)。
1、肝局灶性結(jié)節(jié)性增生Focalnodularhyperplasia(FNH)OutlineFNHaccountsforapproximately8%ofallprimaryhepatictumorandisthesecondmostcommonbenignlivertumorafterhemangioma.Thisbenigntumouroccursmostcommonlyinwomenaged20–50years,butmayoccurinbothmenandwomenatanyage,withmultiplelesionsbe
2、ingfoundin20percentofcases.FNHOralcontraceptive口服避孕藥useisassociatedwithFNHbuttheresponsibilityoforalcontraceptivesintheoccurrenceofthelesionhasnotbeendemonstrated.ClinicalsymptomsFNHisusuallyanincidentalfindingatimagingandonlyone-thirdarediscoveredbecauseofclinicalsy
3、mptomssuchasmildepigastricpainordiscomfortandorpalpableabdominalmass.Bloodlivertestsarenormalinhalfofthecasesandshowonlyincreasedinserumgamma-glutamyl-transpeptidase血清r-谷氨酰轉(zhuǎn)肽酶activityinmostoftheremnants.well-circumscribedlobulatedmasswithcentralscar(arrow)andradiatin
4、gseptations.PathologicalappearanceFNHisdefinedasanodulecomposedofbenign-appearinghepatocytesoccurringinaliverthatisotherwisehistologicallynormal.FNHisahyperplasticliverparenchyma（增生性肝實(shí)質(zhì)）subdividedintonodulesbyfibrousseptathatmayformstellatescars（星狀瘢痕）.Thelesionisusua
5、llysolitary(80%)andmeasureslessthan5cmindiameter.Occasionally,FNHispedunculated(蒂).Photomicrographofhistopathologicspecimenshowsregionsofnodularhepatocellularproliferationseparatedbyradiatingbandsandsurroundingmyxomatousscar(arrows).Themarginissharp,oftenlobulatedand
6、nocapsuleispresent.Hemorrhageandnecrosisarerare.Atmicroscopy,thecentralfibroticzoneisdenseconnectivetissue（致密結(jié)締組織）whichcontainsnumerousabnormallythickwalledarteries.Markedproliferationofbiliarystructuressurroundedbyinflammatorycellsisobservedwithinandattheperiphery（邊
7、緣）ofthefibrousseptae.Kupffercellsarealsoseenwithinthelesion.FNHclassic(80%)non-classic(20%)(a)telangiectaticFNH,(b)withatypia,(c)mixedhyperplasticandadenomatousFNHDiagnosis（CT）NonenhancedCTscansFNHisdemonstratedasafocalhypodenseorisodensemasscomparedwithnormalliver.A
8、centralhypodensescarisdepictedinonlyone-thirdofthecases.Calcificationswithinthecentralscarareveryrareandobservedinonlyabout1%ofthec
