脂肪肝を合併した肝focal nodular hyperplasiaの1例

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A 58-year-old man, who had been treated with sulpyride (300mg daily) for 2 years under the diagnosis of autonomic nervous disorder until 3 months ago, was admitted to our hospital for evaluation of liver dysfunction and a space occupying lesion of the liver. He was obese and with hepatomegaly, slight elevation of serum hepato-biliary enzymes and glucose intolerance. Ultrasonography revealed a low echoic mass involving the posterior superior segment distinct from a surrounding bright liver which was compatible with fatty liver. CT number of the mass was relatively high and RI scintigraphy demonstrated a hot nodule. Hepatic angiography revealed a dilatation ofarteries, a tumor staining in the capillary phase and a filling defect in the portography. These findings led us to diagnose this lesion as FNH. The resected tumor was 6×4.5×4cm in size and yellowish in color, showing a granular appearance and a fibrous scar formation on a cut surface. Histological findings presented a hyalinous scar with dilated vessels and radiating bands of fibrous connectivetissue extending into the parenchyma of the liver. The diagnosis of FNH was histopathologically confirmed. Although FNH is generally difficult to be diagnosed preoperatively, in the present case accompanied fatty liver is thought to make possible to diagnose FNH. A relationship between an effect of sulpyride and FNH was not clarified.
社団法人日本肝臓学会の論文