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中华消化病与影像杂志(电子版) ›› 2017, Vol. 07 ›› Issue (02) : 89 -92. doi: 10.3877/cma.j.issn.2095-2015.2017.02.011

所属专题: 经典病例 经典病例 文献

病例报告

肝门部及肝脏血管周上皮样肿瘤2例报道并文献综述
王刚1, 翟文龙1,(), 叶健文1, 傅哲1, 周闯1, 唐文超1   
  1. 1. 450052 郑州,河南省高等学校肝胆胰外科与消化器官移植重点实验室;450052 郑州大学第一附属医院肝胆胰外科
  • 收稿日期:2016-06-02 出版日期:2017-04-01
  • 通信作者: 翟文龙
  • 基金资助:
    河南省高校科技创新人才支持计划(14HASTIT030)
  • Received:2016-06-02 Published:2017-04-01
引用本文:

王刚, 翟文龙, 叶健文, 傅哲, 周闯, 唐文超. 肝门部及肝脏血管周上皮样肿瘤2例报道并文献综述[J]. 中华消化病与影像杂志(电子版), 2017, 07(02): 89-92.

图1 上腹部增强CT扫描。1A、1D肝门部见类圆形肿块影,大小约26 mm×22 mm,密度均匀,边界清晰;1B增强扫描后动脉期明显强化,似有动脉血供,其内可见细小血管影,肝动脉供血自其旁经过;1C静脉期强化程度略减退
图2 免疫组织化学染色染色(10×20)。2A镜下可见大量的纺锤形及类上皮样细胞,嗜酸性的透明胞浆,正常染色的卵圆核,可见小核仁,细胞沿血管壁周围分布;2B可见HMB-45(+);2C可见Melan A(+);2D可见SMA(+)
图3 上腹部动态增强CT。肝左叶类圆形肿块,密度不均匀,边界欠清晰,2A、2B增强扫描后动脉期呈现显著而不均匀的强化,似动脉血供丰富;2C、2D静脉期强化程度相对减弱
图4 上腹部MRI增强扫描显示。4A肝左叶可见一类圆形肿块,呈长T1混杂长T2信号;4D DWI高b值可见明显弥散受限。静脉注射Gd-DTPA后扫描:4B肝左叶病变在动脉期呈明显不均匀强化;4C门脉期及静脉期信号降低呈低信号
图5 HE染色(10×20)。5A镜下可见血管壁增厚,周围有大量类上皮样细胞呈巢团状及条索状分布,嗜酸性胞浆透明淡染,细胞核呈卵圆形,可见小核仁,无核分裂。免疫组织化学染色:5B HMB45(+);5C Melan A(+);5D SMA(+);5E Desmin(灶+);5F TFE-3(+)
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