肝の Fibrolamellar Carcinoma の一切除例

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A case of fibrolamellar carcinoma of the liver (FCL) is presented. A 21-year-old Japanese man was admitted to our hospital with chief complaint of right hypochondralgia. Abdominal plain CT scan showed a low density tumor in the anterior and medial segment of the liver. A center of tumor was not enhanced by dynamic CT. Angiography revealed marked neovascularity. Anterior and medial segmentectomy of the liver was performed.<BR>The resected hepatic specimen revealed a central stellate scar and calcifications. Histological appearance of resected tumor showed intermixing of broad fibrous strands and clusters of carcinoma cells which have eosinophilic cytoplasma. Fibrous strands showed lamellar stream. This tumor was diagnosed as a fibrolamellar carcinoma of the liver.<BR>Imaging of FCL in the literature was discussed. Grossly and clinically, focal nodular hyperplasia (FNH) simulate with FCL. The appearance of the central scar may permit distinction of FCL from FNH, as that of FCL is poorly vascularized.<BR>From this point, dynamic CT and MRI may be useful for the differential diagnosis between FCL and FNH.
社団法人日本肝臓学会の論文