肝癌误诊为肝脏局灶性结节性增生5例临床分析

Clinical analysis of five cases of hepatocellular carcinoma misdiagnosed as liver focal nodular hyperplasia

目的分析5例肝癌误诊为肝脏局灶性结节性增生(FNH)的原因,探讨FNH与肝癌的鉴别诊断。方法回顾性分析2008年1月-2011年12月间术前误诊为FNH的5例肝癌患者的临床资料。结果彩超检查发现肝内低回声或不均质回声肿物,增强CT检查3例,增强MRI检查2例,部分病例可见中央瘢痕。术前诊断为FNH,所有病例均行手术切除,病理为肝细胞癌。结论合并肝炎时诊断FNH一定谨慎,正确应用和分析增强CT和MRI检查是诊断正确的关键。

Objective To investigate the causes of misdiagnosis of hepatocellular carcinoma （HCC） as focal nodular hyperplasia （ FNH）, and to evaluate potential differential diagnostic features between the two diseases. Methods Retrospective analysis was carried out for five patients initially diagnosed with FNH and confirmed as HCC after surgery between January 2008 and December 2011. Results The liver masses were initially indicated by ultrasound examination showing low echo areas or echo intensity inequality. Three of the cases underwent enhanced computed tomography （CT） examination, and two cases underwent enhanced magnetic resonance imaging （MRI） examination. A central scar was present in some of the cases. All of the cases were diagnosed with FNI-I by imaging findings and underwent surgical resec- tion, after which pathology findings confirmed the HCC diagnosis. Conclusion The diagnosis of FNH in patients with hepatitis should be carefully considered for differential diagnosis of HCC. Imaging findings from enhanced CT and MRI may provide reveal differential features.