A RESECTED CASE OF HEPATIC ADENOMATOUS HYPERPLASIA MIMICKING HEPATIC CELL CARCINOMA

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A 60-year-old man was pointed out having an imparied liver function during hospital stay for a fracture of the left patella. Ultrasonography revealed a tumorous lesion with a diameter of 15 mm presenting as low internal echo in the anterior upper segment (S8) of the liver. Dynamic CT showed a high density mass in the same region. With echo-guided needle biopsy cytology, a diagnosis of focal nodular hyperplasia (FNH) was attained. However, AFP level was high, angiography revealed abnormal hypervascularization and deep stained tumor, and another diagnosis of hepatic cell carcinoma was not able to be ruled out. Operation was performed. Macroscopic findings of the resected specimen included that the tumor was ill-defined, the section slightly swelled, and no capsulation with connective tissue was confirmed. Histopathologically cells with mild atypical nucleus were observed here and there, the patient being diagnosed as adenomatous hyperplasia (AH). This paper describes this case of AH which presented difficulty in differentiatial diagnosis from hepatic cell carcinoma, together with some notes.

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