在接受化疗的癌症幸存者的随访过程中新发现的肝结节可能会造成诊断困境。我们调查了癌症幸存者中一系列通过典型 MRI 特征和随访或病理学诊断的肝局灶性结节性增生 (FNH)。这项回顾性研究评估了 38 名在环磷酰胺治疗后出现新肝 FNH 的肿瘤患者 (n = 19)和基于奥沙利铂的 (n = 19) 化疗。主要肿瘤类型为乳腺癌（n = 18）和结直肠癌（n = 17）。报告了所有目标肝脏病变 (n = 63) 的 MRI 结果、临床特征和时间演变。此外，对两个化疗药物组进行比较。化疗完成与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，其余患者根据典型的 MRI 特征和长期随访进行诊断。在患者中，60.5%（23/38）出现多发结节，并检测到 63 个靶病灶。目标病灶的中位尺寸为 11.5 毫米（8.4，15.1）。中位随访时间为32.5个月（21.2个月，48.6个月），15名患者在随访期间皮损发生变化（11名患者增加，4名患者减少）。与以奥沙利铂为基础的化疗组相比，以环磷酰胺为基础的治疗组人口更年轻，女性比例更高，发现时间更短（均 p≤0.016）。在接受环磷酰胺或奥沙利铂为基础的化疗后，癌症幸存者可能会发生 FNH化疗。考虑患者的治疗史和典型的 MRI 结果有助于避免误诊和不必要的侵入性治疗。当癌症幸存者在随访过程中出现新的肝结节时，临床医生除了肝转移外，还应考虑局灶性结节增生的可能性，特别是如果癌症幸存者幸存者之前接受过环磷酰胺或奥沙利铂治疗。癌症幸存者在化疗后可出现肝局灶性结节性增生。环磷酰胺和奥沙利铂是两种易于发生局灶性结节性增生的化疗药物。使用环磷酰胺治疗的患者会以较短的时间间隔出现局灶性结节性增生。© 2024。作者。

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.© 2024. The Author(s).