Focal Nodular Hyperplasia-Like Nodule with Reduced Expression of Organic Anion Transporter 1B3 in Alcoholic Liver Cirrhosis
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概要
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We report a patient with alcoholic liver cirrhosis who had a 15 mm focal nodular hyperplasia (FNH)-like nodule in the liver. This FNH-like nodule was diagnosed as hepatocellular carcinoma (HCC) mainly based on hypervascularity during the hepatic arterial phase, washout pattern during the equilibrium phase and low signal intensity during the hepatobiliary phase in gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI; it was surgically resected. Its histology exhibited hepatocyte hyperplasia, fibrous septa containing unpaired small arteries accompanied by reactive bile ductules, remarkable iron deposits and sinusoidal capillarization, and was compatible with the diagnosis of an FNH-like nodule. When we analyzed the images of the present nodule retrospectively, low signal intensity on in-phase and isosignal intensity on opposed-phase T1-weighted MRI may have reflected iron deposits in the FNH-like nodule. In addition, a low signal intensity on T2-weighted MRI and no detection in diffusion-weighted MRI may help in distinguishing FNH-like nodules from HCC, since these image findings are inconsistent with typical HCC. Immunohistochemical analysis revealed a markedly reduced expression of organic anion transporter (OATP) 1B3 in this nodule, which implied decreased Gd-EOB-DTPA uptake by hepatocytes and accounted for the low signal intensity during the hepatobiliary phase on Gd-EOB-DTPA-enhanced MRI. To the best of our knowledge this is the first report in which an FNH-like nodule was assessed for OATP1B3 expression.
著者
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Hino Keisuke
Department Of Basic Laboratory Sciences Yamaguchi University Graduate School Of Medicine
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Kojiro Masamichi
Department Of Gastroenterology And Hepatology Kinki University School Of Medicine
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URAKAMI ATSUSHI
Department of Gastroenterological Surgery, Kawasaki Medical School
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NAKASHIMA OSAMU
Department of Pathology and Research Center of Innovative Cancer Therapy of the 21st Century COE Pro
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Korenaga Masaaki
Department Of Gastroenterology And Hepatology Graduate School Of Medicine Yamaguchi University
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Korenaga Keiko
Department Of Gastroenterology And Hepatology Graduate School Of Medicine Yamaguchi University
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Hara Yuichi
Department Of Gastroenterology And Hepatology Yamaguchi University School Of Medicine
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Moriya Takuya
Department Of Dermatology Department Of Pathology
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Yoshida Koji
Department Of Biochemistry Kinki University School Of Medicine
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Tomiyama Yasuyuki
Department Of Respiratory Medicine Faculty Of Life Sciences Kumamoto University
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Hino Keisuke
Departments of Hepatology and Pancreatology, Kawasaki Medical University, Japan
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Moriya Takuya
Department of Pathology, Kawasaki Medical University, Japan
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Doi Nobuko
Departments of Hepatology and Pancreatology, Kawasaki Medical University, Japan
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Kawase Tomoya
Departments of Hepatology and Pancreatology, Kawasaki Medical University, Japan
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Nishina Sohji
Departments of Hepatology and Pancreatology, Kawasaki Medical University, Japan
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Yoshioka Naoko
Departments of Hepatology and Pancreatology, Kawasaki Medical University, Japan
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Nishina Sohji
Department of Hepatology and Pancreatology, Kawasaki Medical School, Japan
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Yoshioka Naoko
Department of Biological Sciences, Faculty of Science, Nara Women's University
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Hara Yuichi
Departments of Hepatology and Pancreatology, Kawasaki Medical University, Japan
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Kojiro Masamichi
Department of Pathology, Kurume University School of Medicine, Japan
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