摘要
目的观察肝腺瘤样增生(AH)的临床病理特点,探讨该病的诊断与鉴别诊断。方法回顾分析12例手术切除的AH的临床表现、组织形态学及免疫表型特征,并结合文献复习。结果12例中9例男性,3例女性,平均年龄48.8岁。多有慢性肝炎病史。血清学11例HBsAg(+),9例AFP(-)。影像学上表现为肝实质性占位,动脉期增强。组织学上有肝硬化背景,肝细胞有不同程度异型增生,可见大细胞异型增生(LCD)和小细胞异型增生(SCD);免疫组化CD34染色显示高度不典型增生(HGDN)有散在阳性小血管,癌变灶阳性小血管有所增多。结论AH的发生是晚期肝硬化向肝细胞癌演变的一个重要组织学改变,HGDN是重要的癌前病变。手术完整切除预后好。
Objective To explore the clinicopathological features and differential diagnosis of hepatic adenomatous hyperplasia （AH）. Methods 12 eases of AH resected by operation were studied with clinical features, conventional histopathological and immunohistochemical stains. Results The mean age of 12 patients was 48.8 years, of which nine were male. Most of them had the history of chronic HBV infection. 11 patients were positive for serum HBsAg and nine cases were. negative for AFP. The uhrasonography and CT scanning revealed solid lesions in the liver, the blood flow increased in the arterial phase. In the backgrounds of liver cirrhosis, liver cells presented histologically different grade of dysplasia, including LCD and SCD. The scattered small vessels of high grade dysplasia nodule （HGDN） were immunohistochemical positive for CD34, which were increased in cancerous lesion. Conclusions The occurrence of AH is a pivotal histological lesion from the late stage of liver cirrhosis to hepatocellular carcinoma, and HGDN is an important precancerous lesion. Complete surgical removal is recommended with a better prognosis.
出处
《诊断病理学杂志》
CSCD
2005年第6期429-431,i0014,共4页
Chinese Journal of Diagnostic Pathology
关键词
肝腺瘤样增生
病理学
临床
Liver adenomatous hyperplasia
Pathology
Clinical
