fnh肝局灶性结节性增生.pptVIP

肝局灶性结节性增生 Focal nodular hyperplasia (FNH) Outline FNH accounts for approximately 8% of all primary hepatic tumor and is the second most common benign liver tumor after hemangioma. This benign tumour occurs most commonly in women aged 20–50 years, but may occur in both men and women at any age, with multiple lesions being found in 20 per cent of cases. FNH Oral contraceptive口服避孕药 use is associated with FNH but the responsibility of oral contraceptives in the occurrence of the lesion has not been demonstrated. Clinical symptoms FNH is usually an incidental finding at imaging and only one-third are discovered because of clinical symptoms such as mild epigastric pain or discomfort and or palpable abdominal mass . Blood liver tests are normal in half of the cases and show only increased in serum gamma-glutamyl-transpeptidase血清r-谷氨酰转肽酶 activity in most of the remnants . well-circumscribed lobulated mass with central scar (arrow) and radiating septations. Pathological appearance FNH is defined as a nodule composed of benign-appearing hepatocytes occurring in a liver that is otherwise histologically normal. FNH is a hyperplastic liver parenchyma （增生性肝实质）subdivided into nodules by fibrous septa that may form stellate scars（星状瘢痕）. The lesion is usually solitary (80%) and measures less than 5 cm in diameter . Occasionally, FNH is pedunculated(蒂). Photomicrograph of histopathologic specimen shows regions of nodular hepatocellular proliferation separated by radiating bands and surrounding myxomatous scar (arrows). The margin is sharp, often lobulated and no capsule is present . Hemorrhage and necrosis are rare. At microscopy, the central fibrotic zone is dense connective tissue（致密结缔组织） which contains numerous abnormally thickwalled arteries. Marked proliferation of biliary structures surrounded by inflammatory cells is observed within and at the periphery（边缘） of the fibrous septae. Kupffer cells are also seen within the lesion. FNH class