肝局灶性结节性增生18例病理诊断和鉴别诊断

Pathological diagnosis and differential diagnosis of hepatic focal nodular hyperplasia

目的 分析肝局灶性结节性增生 (FNH)的病理组织学分型、病理诊断和鉴别诊断。方法 报道 18例肝局灶性结节性增生 ,主要从病理大体、光镜和免疫组化方面进行观察。结果 18例肝局灶性结节性增生以中青年居多 ,男女之比为 2 6 :1。本组 18例FNH有 14例为经典型 ,2例为毛细血管扩张型 ,1例为混合型 ,1例为伴肝细胞不典型增生型。结论 提出此病的病理诊断要点及分型 ,对肝局灶性结节性增生与肝腺瘤样增生性结节、肝间变性结节状增生、分化好的肝细胞癌。

Obiective To analyse the histopathological type and pathological diagnosis and differential diagnosis of hepatic focal nodular hyperplasia (FNH). Methods Eighteen cases of FNH were studied with gross and microscopic examination and immunohistochemical staining. Results The majority of the patients were middle aged. The patient population was composed of 13 males and 5 females (sex ratio,2.6:1). According to histological structures, 18 cases were divided into classicall type (14 cases), telangiectic type (2 cases), mixed type (1 case),and 1 case with hepetocellular atypia. Conclusions The key point for the diagnosis and type of the FNH were discussed. Its differential diagnosis includes hepatic adenomatous hyperplasia nodule, hapatic anaplasia nodular haperplasia, hepatocellular carcinoma, fibrolamellar hepatocellular carcinoma and hepatocellular adenoma.