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Annals of Nuclear Medicine and Molecular Imaging

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篇名 [fee6]Tc-Sulfur Colloid Liver SPECT in an Atypical Hepatocellular Carcinoma Mimic Focal Nodular Hyperplasia
卷期 13:4
並列篇名 肝硬化合併肝癌病人疑似良性結節性增生之鎝-99m硫膠體SPECT掃描
作者 任祖剛黃文盛張宏達周榮茂
頁次 251-254
關鍵字 肝臟閃爍造影肝細胞癌局部結節性增生Liver scintigraphyHepatocellular carcinomaFocal nodular hyperplasia
出刊日期 200012

中文摘要

     一位66歲女性抱怨間斷性右上腹部病痛有2年,超音波發現在右肝葉(第6節段)有低回音結節。電腦斷層檢查則呈現直徑約3公分之疑似局部性肝結節增生。此一病灶在磁振造影檢查時亦未能與肝細胞癌作明顯區別。病人血中胎兒蛋白及胚源抗原數值均呈陰性,臨床病史及病人微狀促使外科醫師利用鎝-99m硫膠體肝臟閃爍造影做進一步評估,肝臟閃爍造影則在先前電腦斷層檢查所出現之病灶成呈冷區,認為肝細胞癌可能性較大。經病理檢查證實為一合併肝硬化之小肝細胞癌,病人接受雙節段肝切除及膽囊切除,後者亦證實為慢性膽囊炎。

英文摘要

     A 66-year-old woman complained right epigastric pain off and on for 2 years. She was referred to our hospital because sonography showed a hyperechoic nodule in the lower portion of her right hepatic lobe (segmental 6). The computerized tomography showed a feature of focal nodular hyperplasia (FNH). The magnetic resonance image was non-diagnostic between hepatocellu-lar carcinoma (HCC) and FNH. Both serum alpha fetoprotein and carcinoma embryonic antigens are in nor- mal ranges. Radionuclide colloid liver scintigraphy showed a photopenic area in the corresponding site seen on the radiological examinations. Histologic analysis indicated a picture of HCC with cirrhosis. FNH is a benign liver abnormality. No therapy is recommended unless complications occur. HCC, on the other hand, is fatal malignancy. Cirrhosis and HCC have become common causes of people death in Taiwan. Differential diagnosis between FNH and HCC is thus clinically important.

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