Misdiagnosed as cholangiocarcinoma in 1 case of hepatic focal nodular hyperplasia.doc

 PAGE \* MERGEFORMAT 7 Misdiagnosed as cholangiocarcinoma in 1 case of hepatic focal nodular hyperplasia Study: Social Fu Wang Weiyang Liang Cao Jinsong Lin Guocheng [Keywords:] hepatic focal nodular hyperplasia (FNH); bile duct carcinoma, computed tomography Case Information Patients, female, 67 years old, “accompanied by the xiphoid pain under fatigue, anorexia March” admission, physical examination: scleral jaundice, and right lower quadrant pain xiphoid under pressure, no rebound pain. Laboratory: γ-GT 303, ALT 78 U / L, AST 80U / L, I was no exception. B-Tip: (1) gallstones and cholecystitis, (2) common bile duct, intrahepatic bile duct dilatation and stones, (3), left lobe of liver See size of about 5.4 × 4.0cm irregular hypoechoic mass, ill-defined, and its uneven distribution within the echo. outside the hospital CT scan showed: (1) gallstones and cholecystitis, (2) common bile duct, intrahepatic bile duct dilatation and stones, (3) occupying the left hepatic lobe. enhanced CT in our hospital showed left lateral lobe of liver lesions is approximately 7.0cm × 7.2cm heterogeneous enhancement, the CT value of approximately 62-86Hu, ill-defined, and its may see the expansion of the bile duct, delayed scans showed heterogeneous enhancement, it seems like enhancement was separated, left branch of portal vein showed unclear. CT diagnosed: (1) gallstones and cholecystitis; (2) common bile duct, intrahepatic bile duct dilatation and stones; (3) left lobe of liver lesions, considered as malignant, the possibility of large bile duct carcinoma. (Figure 1,2 laparotomy surgery: complete “cholecystectomy + choledochotomy + T lithotomy tube drainage, “after the probe left lobe of liver bulky hard, uneven surface, surgery can not be completely removed in the left lobe of liver taken at the interlobar fissure close to 1.0cm × 1.0cm quality hard mass biopsy, followed by the abdomen was closed layer , of surgery. Pathology: focal nodular hyperplasia of the left