内容紹介
Summary
A 64-year-old woman who had chronic type C viral hepatitis was referred with a liver tumor detected by magnetic resonance imaging(MRI). She had a history of rheumatoid arthritis which was treated by methotrexate. Ethoxybenzyl-MRI(EOB-MRI)showed a low signal in the T1-weighted imaging, a high signal in the T2-weighted imaging and a low signal in the hepatobiliary phase. The tumor was 7 millimeters in diameter at S4, and exhibited enhancement in the arterial phase and wash out in the portal phase by contrast enhanced CT. Imaging findings suggested hepatocellular carcinoma, and we performed partial hepatectomy of S4. Histopathological examination confirmed reactive lymphoid hyperplasia(RLH)of liver. RLH of liver is a rare benign lesion and it is necessary to consider RLH as a differential diagnosis of the liver tumor.
要旨
症例は64歳,女性。C型慢性肝炎で経過観察中に腹部MRI検査で肝腫瘍を指摘された。既往に慢性関節リウマチがあり,メトトレキサート内服中であった。EOB-MRIにおいて,腫瘍はT1強調画像で低信号,T2強調画像で高信号,肝細胞相で低信号を呈した。腹部CT検査ではS4に早期相で造影され,後期相でwash outされる径7 mm大の結節を認めた。画像診断は原発性肝細胞癌とし,肝S4部分切除術を施行した。病理組織学的検査では肝reactive lymphoid hyperplasia(RLH)と診断された。本疾患はまれな良性疾患であり,肝腫瘍の鑑別診断として念頭に置く必要がある。
目次
A 64-year-old woman who had chronic type C viral hepatitis was referred with a liver tumor detected by magnetic resonance imaging(MRI). She had a history of rheumatoid arthritis which was treated by methotrexate. Ethoxybenzyl-MRI(EOB-MRI)showed a low signal in the T1-weighted imaging, a high signal in the T2-weighted imaging and a low signal in the hepatobiliary phase. The tumor was 7 millimeters in diameter at S4, and exhibited enhancement in the arterial phase and wash out in the portal phase by contrast enhanced CT. Imaging findings suggested hepatocellular carcinoma, and we performed partial hepatectomy of S4. Histopathological examination confirmed reactive lymphoid hyperplasia(RLH)of liver. RLH of liver is a rare benign lesion and it is necessary to consider RLH as a differential diagnosis of the liver tumor.
要旨
症例は64歳,女性。C型慢性肝炎で経過観察中に腹部MRI検査で肝腫瘍を指摘された。既往に慢性関節リウマチがあり,メトトレキサート内服中であった。EOB-MRIにおいて,腫瘍はT1強調画像で低信号,T2強調画像で高信号,肝細胞相で低信号を呈した。腹部CT検査ではS4に早期相で造影され,後期相でwash outされる径7 mm大の結節を認めた。画像診断は原発性肝細胞癌とし,肝S4部分切除術を施行した。病理組織学的検査では肝reactive lymphoid hyperplasia(RLH)と診断された。本疾患はまれな良性疾患であり,肝腫瘍の鑑別診断として念頭に置く必要がある。