基于环磷有或奥沙利帕素化疗后患者随访期间的肝局灶性结节增生：与肝转移的分化

在接受化疗的癌症幸存者随访期间，新发现的肝结节可能构成诊断困境。我们研究了一系列通过典型的MRI特征和癌症幸存者中诊断出的肝结节增生（FNH）。这项回顾性研究评估了38例在基于环磷酰胺后（n = 19）和基于oxaliplepartin的基于oxaliplepriptin的（n = 19）的肿瘤患者，这些患者在基于环磷酰胺后开发了新的肝FNH。主要肿瘤类型是乳腺癌（n = 18）和结直肠癌（n = 17）。报告了所有靶肝病变的MRI发现，临床特征和时间演变（n = 63）。此外，比较了两个化疗药物组。化学疗法完成与FNH检测之间的中位间隔为30.4个月（12.9，49.4）。六名患者接受了活检或手术，而其余患者则根据典型的MRI特征和长期随访诊断。在患者中，检测到60.5％（23/38）有多个结节和63个目标病变。靶病变的中位数为11.5毫米（8.4，15.1）。中位随访时间为32.5个月（21.2、48.6），在随访期间，病变发生变化（增加了11例，减少了4例）。基于环磷酰胺的治疗组的人群年龄较小，女性比例更高，并且发现了比基于奥沙利铂的化学疗法组更短的发现时间（所有P≤0.016）。FNH可能发生在环磷酰胺或基于oxataliplatipin的化学疗法后，可能发生在癌症幸存者中。 Considering a patient's treatment history and typical MRI findings can help avoid misdiagnosis and unnecessary invasive treatment.When cancer survivors develop new hepatic nodules during follow-up, clinicians should think of the possibility of focal nodular hyperplasia in addition to liver metastasis, especially if the cancer survivors were previously treated with cyclophosphamide or oxaliplatin.Cancer survivors, after chemotherapy, can发展肝局灶性结节增生。环磷酰胺和奥沙利铂是两种化学治疗剂，易于局灶性结节增生。局灶性结节增生以较短的间隔发生在用环磷酰胺治疗的患者中。

Newly detected hepatic nodules during follow-up of cancer survivors receiving chemotherapy may pose a diagnostic dilemma. We investigated a series of hepatic focal nodular hyperplasia (FNH) diagnosed by either typical MRI features and follow-up or pathology in cancer survivors.This retrospective study evaluated 38 patients with tumours who developed new hepatic FNH after cyclophosphamide-based (n = 19) and oxaliplatin-based (n = 19) chemotherapies. The main tumour types were breast cancer (n = 18) and colorectal cancer (n = 17). MRI findings, clinical features, and temporal evolution of all target hepatic lesions (n = 63) were reported. In addition, the two chemotherapy drug groups were compared.The median interval between chemotherapy completion and FNH detection was 30.4 months (12.9, 49.4). Six patients underwent biopsy or surgery, while the remaining patients were diagnosed based on typical MRI features and long-term follow-up. Among the patients, 60.5% (23/38) presented with multiple nodules and 63 target lesions were detected. The median size of target lesions was 11.5 mm (8.4, 15.1). The median follow-up time was 32.5 months (21.2, 48.6), and 15 patients experienced changes in their lesions during the follow-up period (11 increased and 4 decreased). The cyclophosphamide-based treatment group had a younger population, a greater proportion of females, and a shorter time to discovery than the oxaliplatin-based chemotherapy group (all p ≤ 0.016).FNH may occur in cancer survivors after cyclophosphamide- or oxaliplatin-based chemotherapy. Considering a patient's treatment history and typical MRI findings can help avoid misdiagnosis and unnecessary invasive treatment.When cancer survivors develop new hepatic nodules during follow-up, clinicians should think of the possibility of focal nodular hyperplasia in addition to liver metastasis, especially if the cancer survivors were previously treated with cyclophosphamide or oxaliplatin.Cancer survivors, after chemotherapy, can develop hepatic focal nodular hyperplasia. Cyclophosphamide and oxaliplatin are two chemotherapeutic agents that predispose to focal nodular hyperplasia development. Focal nodular hyperplasia occurs at shorter intervals in patients treated with cyclophosphamide.