Imaging of focal nodular hyperplastic-like nodules in alcoholic liver cirrhosis patients using gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid magnetic resonance imaging |
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Authors: | Hisamitsu Miyaaki Tatsuki Ichikawa Naota Taura Satoshi Miuma Makiko Kawaguchi Ryota Kohno Hajime Isomoto Fuminao Takeshima Osamu Nakashima Kazuhiko Nakao |
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Institution: | (1) Department of Gastroenterology and Hepatology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan;(2) Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, Japan |
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Abstract: | We report on two patients with a history of alcohol abuse who presented with multiple hepatic nodules. Dynamic computed tomography
revealed multiple nodular lesions, which were enhanced at the early contrast phase and washed out at the portal phase. In
the hepatobiliary phase using gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid magnetic resonance imaging (Gd-EOB-DTPA
MRI), these tumors did not show any uptake, thus suggesting the presence of hepatocellular carcinoma. An ultrasound-guided
biopsy revealed a slight increase in cell density, sinusoidal dilatation, and contained unpaired small arteries. According
to immunohistochemical analyses, these arteries were positive for CD34 and alpha-smooth muscle actin. From these findings,
the nodules were diagnosed to be focal nodular hyperplastic (FNH)-like nodules arising in alcoholic-cirrhosed livers. The
differential diagnosis of FNH-like nodules arising in alcoholic liver cirrhosis and hepatocellular carcinoma is difficult
with Gd-EOB-DTPA MRI, and therefore histological confirmation is necessary. |
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Keywords: | |
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