ACASNE ONF DU-PAN-2 PRODUCING NFOCAL NODUNLAR HYPERPLASIA OF THE LIVER DU-PAN-2

Abstract

We reported a case of DU-PAN-2 producing focal nodular hyperplasia of the liver (FNH), which was not stained following ICG infusion under laparoscopic observation. A 28-year-old woman was pointed out a liver mass by an ultrasonographic examination and admitted to our hospital. There were no remarkable findings in physical examinations and laboratory data except elevated serum level of DU-PAN-2. Ultrasonography, CT, MRI and angiography showed a hypervascular tumor(13×12×8cm3)with central stellate fibrosis in the left hepatic lobe, suggesting FNH. To differentiate from hepatocellular carcinoma, laparoscopy was performed. A white-reddish tumor covered with networks of fine vessels was observed. The tumor was not stained following intravenous injection of ICG(3mg/kg body weight). Because we could not exclude fibrolamellar hepatocellular carcinoma, the extended left lobectomy was performed. FNH was histologically con-firmed. Elevated serum level of DU-PAN-2 returned to a normal value after the resection. Immunohistochemical staining of the resected specimen revealed that proliferating ductular hepatocytes and some hepatocytes near the ductules in the FNH produced DU-PAN-2.