糖尿病の若年女性に生じた炎症性肝細胞腺腫の1例

A case of inflammatory hepatocellular adenoma associated in a young woman with diabetes mellitus

肝細胞腺腫は現在遺伝子学的，臨床病理学的に4つのサブタイプに分類されている^1）2）。この亜分類が2010年にWHO分類^3）に取り入れられてから，各亜型ごとの臨床的，画像的特徴の報告が相次いでいるが，基本的には我が国ではまれな病態であり，複数の鑑別が挙がる多血性肝腫瘍として術前画像診断に難渋することが多いのが実状である。今回，糖尿病に罹患した若年女性に生じた炎症性肝細胞腺腫の1例を経験したので，若干の文献的考察を加えて報告する。

We report a case of inflammatory hepatocellular adenoma, which is a rare tumor in Japan. The patient was a 30’s-year-old woman with diabetes mellitus who was not taking oral contraceptives. Dynamic contrast-enhanced CT revealed a lesion in segment 6 that showed homogeneous and slight-to-moderate enhancement in the portal phase with persistent enhancement during the portal and equilibrium phases. On MR imaging, the lesion demonstrated hyperintensity on T2- and diffusion-weighted images and hypointensity in the hepatobiliary phase of gadoxetic-acid-enhanced MR imaging. In addition to the main lesion, two hypointense lesions were seen in the hepatobiliary phase. Partial hepatectomy of segment 6 was performed laparoscopically, and the lesion was pathologically confirmed to be a inflammatory hepatocellular adenoma.