肝局灶性结节性增生的鉴别诊断

目的 分析肝局灶性结节性增生(FNH)的病理形态学特点、病理诊断和鉴别诊断.方法 回顾7例FNH患者临床病理资料,采用HE染色并结合免疫组织化学观察其形态特点.结果 男性4例,女性3例,年龄19～52岁,中位年龄34岁.组织学上有特征性中央纤维星状瘢痕、异常结节状结构、畸形血管和毛细胆管增生.7例FNH中5例为经典型,1例为毛细血管扩张型,1例为混合型.结论 FNH为肝脏良性增生性病变,组织学上应与肝细胞腺瘤、肝腺瘤样结节增生、分化好的肝细胞肝癌和肝纤维板层癌进行鉴别.

Pathological analysis and differential diagnosis of hepatic focal nodular hyperplasia

Objective　To investigate the diagnostic pathological features of focal nodular hyperplasia(FNH) in liver. Methods　7 cases with FNH were studied retrospectively on the basis of hematoxylin and eosin staining and immunohistochemistry. Results　Of the 7 patients aged 19~52 years (mean 34 years), 4 were males and 3 were females. 5 were classical type, one was telangiectic type and one was mixed type, microscopically. The classical form of FNH was defined by the presence of 4 characteristic histologic features: nodular central stellate scars, abnormal nodular architecture, malformed vessels and cholangiolar proliferation. Conclusion　FNH is a benign hepatocylic lesion. It should be differentiated from hepatic adenomatous hyperplasia nodule, hepatocellular adenoma, fibrolamellar hepatocellalar carcinoma and well-differentiated hepatocellular carcinoma.