目的 探討肝血管平滑肌脂肪瘤(HAML)的CT表現(xiàn)及相關(guān)臨床特點(diǎn)。
方法 回顧性分析3例經(jīng)手術(shù)病理確診的HAML患者的臨床、CT及病理資料,分析其影像學(xué)表現(xiàn)及特點(diǎn)。
結(jié)果 3例患者均為女性,其中2例有腹痛表現(xiàn),1例無任何癥狀。2例實(shí)驗(yàn)室檢查均正常,1例除乙肝標(biāo)志物(+)外,其余正常。CT表現(xiàn): 腫瘤位于肝右葉前上段1例,右葉后下段1例,左內(nèi)葉1例; 腫塊內(nèi)可見脂肪成分及軟組織成分,其中脂肪成分CT值為-80~-20 HU(平均-50 HU); 增強(qiáng)后均有不同程度強(qiáng)化,可見強(qiáng)化血管影。術(shù)中見均為外生性包塊。免疫組化染色HMB45(+)、αSMA(+)、S100(+),符合血管平滑肌脂肪瘤的診斷。
結(jié)論 HAML是一種少見的良性腫瘤,其影像學(xué)表現(xiàn)有一定特征性,確診有賴于免疫組化檢測(cè)HMB-45。
引用本文: 路濤,周翔平,姜興蓮,劉翔. 肝血管平滑肌脂肪瘤的影像學(xué)表現(xiàn)及其診斷(附3例報(bào)道). 中國(guó)普外基礎(chǔ)與臨床雜志, 2010, 17(8): 860-864. doi: 復(fù)制
版權(quán)信息: ?四川大學(xué)華西醫(yī)院華西期刊社《中國(guó)普外基礎(chǔ)與臨床雜志》版權(quán)所有,未經(jīng)授權(quán)不得轉(zhuǎn)載、改編
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- 1. Tang LH, Hui P, GarciaTsao G, et al. Multiple angiomyolipomata of the liver: a case report [J]. Mod Pathol, 2002; 15(2): 167171.
- 2. Nguyen TT, Gorman B, Shields D, et al. Malignant hepatic angiomyolipoma: report of a case and review of literature [J]. Am J Surg Pathol, 2008; 32(5): 793798.
- 3. Deng YF, Lin Q, Zhang SH, et al. Malignant angiomyolipoma in the liver: a case report with pathological and molecular analysis [J]. Pathol Res Pract, 2008; 204(12): 911918.
- 4. Kannangai R, Diehl AM, Sicklick J, et al. Hepatic angiomyolipoma and hepatic stellate cells share a similar gene expression profile [J]. Hum Pathol, 2005; 36(4): 341347.
- 5. Nonomura A, Minato H, Kurumaya H. Angiomyolipoma predominantly composed of smooth muscle cells: problems in histologic diagnosis [J]. Histopathology, 1998; 33(1): 2027.
- 6. Sturtz CL, Dabbs DJ. Angiomyolipomas: the nature and expression of the HMB45 antigen [J]. Mod Pathol, 1994; 7(8): 842845.
- 7. Wang SN, Tsai KB, Lee KT. Hepatic angiomyolipoma with trace amounts of fat: a case report and literature review [J]. J Clin Pathol, 2006; 59(11): 11961199.
- 8. Tsui WM, Colombari R, Portmann BC, et al. Hepatic angiomyolipoma: a clinicopathologic study of 30 cases and delineation of unusual morphologic variants [J]. Am J Surg Pathol,1999; 23(1): 3438.
- 9. Petrolla AA, Xin W. Hepatic angiomyolipoma [J]. Arch Pathol Lad Med, 2003; 132(10): 16791682.
- 10. Low SC, Peh WC, Muttarak M, et al. Imaging features of hepatic angiomyolipoma [J]. J Med Imaging Radiat Oncol, 2008; 52(2): 118123.
- 11. Li T, Wang L, Yu HH, et al. Hepatic angiomyolipoma: a retrospective study of 25 cases [J]. Surg Today, 2008; 38(6): 529535.
- 12. Ji Y, Zhu X, Xu J, et al. Hepatic angiomyolipoma: a clinicopathologic study of 10 cases [J]. Chin Med J (Engl), 2001; 114(3): 280285.
- 13. Yang B, Chen WH, Li QY, et al. Hepatic angiomyolipoma: dynamic computed tomography features and clinical correlation [J]. World J Gastroenterol, 2009; 15(27): 34173420.
- 14. Ahmadi T, Itai Y, Takahashi M, et al. Angiomyolipoma of the liver: significance of CT and MR dynamic study [J]. Abdom imaging, 1998; 23(5): 520526.
- 15. Wang YJ, Wang YC, Chien CC, et al. Diagnosis of hepatic angiomyolipoma using CT: report of three cases and review of the literature [J]. Clin Radiol, 2009; 64(3): 329334.
- 16. 馬云海, 李健生, 陸桂君. 肝血管平滑肌脂肪瘤的臨床病理分析 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2005; 12(2): 179180.
- 17. Jiang TA, Zhao QY, Chen MY, et al. Diagnostic analysis of hepatic angiomyolipoma. Hepatobiliary Pancreat Dis Int, 2005; 4(1): 152155.