Two cases of benign hepatic nodules caused by sinusoidal dilatation with different hemodynamics
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CASE REPORT
Two cases of benign hepatic nodules caused by sinusoidal dilatation with different hemodynamics Hiroya Iida1 · Rie Osaki2 · Akiko Matsubara3 · Hiromitsu Maehira1 · Haruki Mori1 · Takehide Fujimoto2 · Akira Andoh2 · Ryoji Kushima3 · Osamu Nakashima4 · Fukuo Kondo5 · Masaji Tani1 Received: 8 November 2019 / Accepted: 24 April 2020 © Japanese Society of Gastroenterology 2020
Abstract We describe two cases of benign nodules caused by sinusoidal dilatation with different hemodynamic statuses. Case 1 was a 50-year-old woman with a 1-cm nodule that showed a low density in the arterial phase of computed tomography. Pathologically, there were no atypical cells with sinusoidal dilatation, and immunostaining was negative for CD34. We speculated that sinusoidal dilatation was caused by congestion due to loss of frequency of the central vein. In contrast, case 2 was a 50-year-old woman with a 1.5-cm nodule that was highly stained in the arterial phase of computed tomography. Although she had a sinusoidal dilatation similar to that in case 1, immunostaining was positive for CD34. Sinusoidal dilatation was thought to be caused by hyperperfusion of arterial blood. Moreover, CD34 may be potentially useful for the differentiation of the hemodynamic status. Keywords Benign hepatic nodule · Sinusoidal dilatation · Hemodynamics · Focal nodular hyperplasia · Hepatic adenoma
Introduction The hemodynamic status of an individual is important for correctly diagnosing hepatic nodules. There are several typical cases of hepatic nodular lesions accompanied by abnormal hepatic blood flow, including focal nodular hyperplasia Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12328-020-01129-0) contains supplementary material, which is available to authorized users. * Hiroya Iida [email protected]‑med.ac.jp 1
Department of Surgery, Shiga University of Medical Science, Seta Tsukinowa‑cho, Otsu, Shiga 520‑2192, Japan
2
Department of Internal Medicine, Shiga University of Medical Science, Seta Tsukinowa‑cho, Otsu, Shiga 520‑2192, Japan
3
Department of Diagnostic Pathology, Shiga University of Medical Science Hospital, Seta Tsukinowa‑cho, Otsu, Shiga 520‑2192, Japan
4
Department of Clinical Laboratory Medicine, Kurume University Hospital, Asahi‑machi 67, Kurume, Fukuoka 830‑0011, Japan
5
Department of Pathology, Teikyo University Hospital, Itabashi‑ku, kaga 2‑11‑1, Tokyo 173‑8605, Japan
(FNH), nodular regenerative hyperplasia, and idiopathic portal hypertension [1–3]; however, we occasionally encounter various atypical cases in daily medical practice. Therefore, evaluation of the hemodynamic status is necessary to understand the pathogenesis of typical and atypical hepatic nodules. Here, we describe two cases involving the resection of benign hepatic nodules that were thought to be caused by sinusoidal dilatation with different hemodynamic statuses, which is unique.
Case reports Case 1 A 50-year-old woman visited Shiga University of Medical Science (SUMS) Hospi
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