杤尾 人司¹, 冨田 周介², 工藤 正俊², 平佐 昌弘², 樫田 博史², 岡部 純弘², 三村 純², 濱田 一美¹, 簑輪 和士¹, 濱田 充生¹, 島田 啓子¹, 森本 義人¹, 伊吹 康良², 小森 英司², 織野 彬雄², 藤堂 彰男²

Hitoshi TOCHIO¹, Syusuke TOMITA², Masatoshi KUDO², Masahiro HIRASA², Hiroshi KASHIDA², Yoshihiro OKABE², Jun MIMURA², Kazumi ONOUE¹, Kazushi MINOWA¹, Michio HAMADA¹, Keiko SHIMADA¹, Yoshito MORIMOTO¹, Yasuyoshi IBUKI², Hideshi KOMORI², Akio ORINO², Akio TODO²

¹神戸市立中央市民病院臨床病理科腹部超音波室, ²神戸市立中央市民病院消化器センター内科

¹Section of Abdominal Ultrasound, Kobe City General Hospital, ²Division of Gastroenterology, Kobe City General Hospital

キーワード : Hypoechoic nodules, Adenomatous hyperplasia, Early hepatocellular carcinoma

The outcome of hypoechoic hepatic nodules less than 1.5 cm in diameter was studied with clinical and ultrasonic follow-up carried out over 3 years. The evidence of hepatocellular carcinoma (HCC) was not obtained by angiography, lipiodol CT, or biopsy in these 55 nodules at the time of initial detection. Three years after detection, enlargement of the nodule size was observed in 9 (16%) of the 55 nodules, while the size had not changed in 19 (35%) nodules. Twentyseven (49%) nodules became undetectable with US. Two of the 9 enlarged nod ules were diagnosed as adenomatous hyperplasia and the remaining 7 nodules were diagnosed as HCC at the final diagnosis. HCC was observed to have occurred in a different area from that of the initially detected nodule lesion in patients with 8 of the 19 "unchanged" nodules and 4 of the 27 nodules that disappeared during the three years follow-up. It was concluded that 13% of the hypoechoic nodules less than 1.5 cm and without signs of malignancy develop to HCC, whereas most of those nodules (49%) become undetectable with US, suggesting those are benign nodules.