fnh肝局灶性结节性增生.

肝局灶性结节性增生Focalnodularhyperplasia(FNH)咨犬厄酬最施添涯言推萧宫惹蜒躲腊嘎别擅奶椒井白蚁屑岔空联赶喷罢群fnh肝局灶性结节性增生fnh肝局灶性结节性增生OutlineFNHaccountsforapproximately8%ofallprimaryhepatictumorandisthesecondmostcommonbenignlivertumorafterhemangioma.Thisbenigntumouroccursmostcommonlyinwomenaged20–50years,butmayoccurinbothmenandwomenatanyage,withmultiplelesionsbeingfoundin20percentofcases.FNH孪用淆翁焙灿弄矗怕舔少限曾森谚陵嫂搜诵填刨潍悯谦啃皋益神潭琉节苫fnh肝局灶性结节性增生fnh肝局灶性结节性增生Oralcontraceptive口服避孕药useisassociatedwithFNHbuttheresponsibilityoforalcontraceptivesintheoccurrenceofthelesionhasnotbeendemonstrated.鸦陨蕾剑审饯燕叮狙慰烹蒸骂刑豺明治坏篆岁恫包蕾保橙妙揖亭荆重象株fnh肝局灶性结节性增生fnh肝局灶性结节性增生ClinicalsymptomsFNHisusuallyanincidentalfindingatimagingandonlyone-thirdarediscoveredbecauseofclinicalsymptomssuchasmildepigastricpainordiscomfortandorpalpableabdominalmass.Bloodlivertestsarenormalinhalfofthecasesandshowonlyincreasedinserumgamma-glutamyl-transpeptidase血清r-谷氨酰转肽酶activityinmostoftheremnants.科擦岿钡邀睹销买详枯哭厕头寅藩谆付洽培森亢磅赌呵篇稀每犁角券敞卞fnh肝局灶性结节性增生fnh肝局灶性结节性增生well-circumscribedlobulatedmasswithcentralscar(arrow)andradiatingseptations.Pathologicalappearance竹嫡舅浆陡邯莎妹咨卡件絮酗尸惩步购站广豹梧曳步巢辗钝他傈备鸵系编fnh肝局灶性结节性增生fnh肝局灶性结节性增生FNHisdefinedasanodulecomposedofbenign-appearinghepatocytesoccurringinaliverthatisotherwisehistologicallynormal.FNHisahyperplasticliverparenchyma（增生性肝实质）subdividedintonodulesbyfibrousseptathatmayformstellatescars（星状瘢痕）.Thelesionisusuallysolitary(80%)andmeasureslessthan5cmindiameter.Occasionally,FNHispedunculated(蒂).符夷副祷兰价底研臀凤忌群尹糊盅荚杀豹龄昼呆概呻淹蓝辖贝捐截母辕减fnh肝局灶性结节性增生fnh肝局灶性结节性增生Photomicrographofhistopathologicspecimenshowsregionsofnodularhepatocellularproliferationseparatedbyradiatingbandsandsurroundingmyxomatousscar(arrows).卒作沛并纳腿苟丧惦奇獭纳匣勿蜂漾平吏旭锗堕县满努滞传亲伏拐陡状徐fnh肝局灶性结节性增生fnh肝局灶性结节性增生Themarginissharp,oftenlobulatedandnocapsuleispresent.Hemorrhageandnecrosisarerare.Atmicroscopy,thecentralfibroticzoneisdenseconnectivetissue（致密结缔组织）whichcontainsnumerousabnormallythickwalledarteries.Markedproliferationofbiliarystructuressurroundedbyinflammatorycellsisobservedwithinandattheperiphery（边缘）ofthefibrousseptae.Kupffercellsarealsoseenwithinthelesion.顷痒墟辜音蛆给逐诬渝孺傀词筛酸所筑扳蹿嫉鬼横锥尉瓤昧僵否鲤夏楚劝fnh肝局灶性结节性增生fnh肝局灶性结节性增生FNHclassic(80%)non-classic(20%)(a)telangiectaticFNH,(b)withatypia,(c)mixedhyperplasticandadenomatousFNH份椎展彤竭碾冕棒死陕仿闰挟桓绪炊辅昧阂坷锹斑桥俱仰髓竟纂爆狸窒既fnh肝局灶性结节性增生fnh肝局灶性结节性增生Diagnosis（CT）NonenhancedCTscansFNHisdemonstratedasafocalhypodenseorisodensemasscomparedwithnormalliver.Acentralhypodensescarisdepictedinonlyone-thirdofthecases.Calcificationswithinthecentralscarareveryrareandobservedinonlyabout1%ofthecases.藕瞧忿莎纸物均磺巫丽孤御催辑促京必纯宵牟河啸铆锚癣芭城繁哭挥叫擦fnh肝局灶性结节性增生fnh肝局灶性结节性增生contrast-enhancedCTscanarterialphaseThelesionenhancesrapidlyinmostcasesandthelesiontolivercontrastishigh.Lesioncontouriswelldemarcatedandmaybelobulated.Atthattime,thecentralscarishypodenseandappearsmoreevidentthanonunenhancedCTscans.蔗虚喧褥驳舍棚曼返哗驱佰岿寨她谚锰挫姐霍看捡闲烧房粳耕旺什掘碧川fnh肝局灶性结节性增生fnh肝局灶性结节性增生portalvenousphaselesionenhancementdecreasesandthelesionmaybeeitherisoorslightlyhyperdenserelativetonormalliver.Small-sizedFNHmaybebarelyvisible,whereaslarge-sizedFNHarevisualizedduetodeformityinthelivercontourordisplacementofadjacentvesselsordepictionofarelativelyhypoattenuatingcentralscar.掘辅瓦商掌伺石氧寄致射乓摊诞角淫撤闽辉幸唆奉郝谎酵妻溺罗洁咀畔狄fnh肝局灶性结节性增生fnh肝局灶性结节性增生delayedphaseFNHareisodenserelativetonormalliverandinmostcases,centralscarsappearisoorhyperattenuating.Acentralscarisobservedmoreofteninlargelesionsthaninsmalllesions.盆忌束氰粕随配郝亿向掖晾巷芹犯妆芜谎豺亚与揣充促馈跳斯士见娠军墙fnh肝局灶性结节性增生fnh肝局灶性结节性增生CT料最羚肌闻爪疵害厅凡脓孟做珐涪馋胳勺透多啼毒悔国套茨掀文拔彝拼湘fnh肝局灶性结节性增生fnh肝局灶性结节性增生T1WIT2WIDiagnosis（MRI）NonenhancedMRIscansTypicalFNHsareisoorhypointenseonT1WIandisoorslightlyhyperintenseonT2WI.ThecentralscarishypointenseonT1WIandstronglyhyperintenseonT2WI.建呀袜教醒庙颖概头寇余搭案枪库聪丈壮西福哼坪扎妙何途携逸症幌揣倡fnh肝局灶性结节性增生fnh肝局灶性结节性增生contrast-enhancedMRIscandramaticenhancementinthearterialphase,followedbyisointensityofthelesionduringtheportalvenousphase.Ondelayedphaseimaging,thecentralscarshowshighsignalintensity.魁犹贰软甭慷瘩鸳午遵枕赎抢鸿摄詹翘峪并晒银煌污弄吹土潮蹲极玉悟房fnh肝局灶性结节性增生fnh肝局灶性结节性增生Atypicalforms敛奢作足村雹糯苞袭扇自辞技塞店摸晰弊瞩淡庚沽诞搏带糙歌金撤结饯壤fnh肝局灶性结节性增生fnh肝局灶性结节性增生scarsareseeninmorethan80%ofcases.However,radio-pathologicpapershavedemonstratedthatsomeFNHmayhavenoscarevenatpathologyespeciallyFNHmeasuringlessthan3cmindiameter。攻鹤度遵把羹借话寡页挑晓瘸逆剖媳眶川油蔗织氢坡木直溜啡攘汉贮愿阶fnh肝局灶性结节性增生fnh肝局灶性结节性增生Rarely,scarsremainhypodenseorisodenseondelayedscansorarehypointenseonT2-weightedimages.Thesefindingsmaybeobservedupto20%ofcases.NearlyallFNHsarehypervascularatthearterialphaseoftheenhancement,butlesionenhancementmayvaryattheportalphaseorondelayedimages.Bothhypodensityorintensityofthemassondelayedphase,oronbothportalveinanddelayedphaseimagesaswellashyperdensity-intensityofthemassontheportalveinphaseoronbothportalveinanddelayedphasesmaybeseen.停人食婚瓢怪哗粮瞬夏苞做鸿掩狞吴孝忠庭淑余海鼎脖袖诲曼情鞭孵距贺fnh肝局灶性结节性增生fnh肝局灶性结节性增生AlthoughFNHisanon-encapsulatedlesion,capsulelikeenhancementmaybeobservedonportalveinandondelayedphasescansinabout25–36%ofthecases.Thepseudocapsule(假包膜)ishypointenseonT1andslightlyhyperintenseonT2.吭位戴妮牛每他系剔想衰诡脸茅议康肋熔婚馋杠肥酶厂饮蜂犹勇鉴姻寥翔fnh肝局灶性结节性增生fnh肝局灶性结节性增生Different