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자료유형
학술저널
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대한병리학회 Journal of Pathology and Translational Medicine Journal of Pathology and Translational Medicine 제45권 제2호
발행연도
2011.1
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160 - 169 (10page)

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Background: This report describes the clinicopathologic findings of six hepatic masses that de­veloped after Kasai hepatic portoenterostomy (HPE) in six patients with longstanding biliary atre­sia (BA). Methods: Hepatic masses were found in six of 55 pediatric patients who underwent liver transplantation for BA after Kasai HPE from 1997 to 2009. Clinicopathologic analysis was per­formed and immunohistochemical staining was carried out for CD34, smooth muscle actin (SMA) and cytokeratin 7. Results: Of the six hepatic masses, two were diagnosed as focal nodular hy­perplasia (FNH)-like lesions, two were large regenerative nodules (LRN), one was a mesenchymal hamartoma (MH) and one was a cholangiocarcinoma. The immunohistochemical staining find­ings for SMA and CD34 were more prominent for the FNH-like nodules than for the cirrhotic back­ground liver. Dysplastic biliary epithelium arising from intestinal metaplasia was found in the chol­angiocarcinoma. Conclusions: Our findings suggest that FNH-like lesions, LRNs and MH are the results of vascular hemodynamic changes after Kasai HPE and that cholangiocarcinoma is due to recurrent cholangitis after BA. All the lesions in this series must be included in the differential diagnosis of a newly formed hepatic mass in patients after portoenterostomy.

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