摘要
目的探讨肝脏上皮样血管平滑肌脂肪瘤(HEAML)的病理表现及CT特征。方法回顾性分析8例经手术病理证实的HEAML患者的临床及CT资料。结果8例均为单发病灶,5例CT平扫为不均匀稍低密度,4例含少量脂肪,1例含丰富的斑片状、片状脂肪。动脉期呈不均匀明显或中等强化,6例呈"快进慢出",2例呈"快进快出"。7例病灶中心和(或)周边出现"中心血管征",且静脉期持续强化。2例出现"静脉早显",3例出现假包膜。8例人黑色素瘤特异性抗体45(HMB45)阳性,6例黑素-A(Melan-A)阳性,4例平滑肌动蛋白(SMA)阳性,3例S-100部分阳性,2例CD34阳性,8例Ki-67不同程度表达(2%~10%),CK、Desmin及甲胎蛋白(AFP)均为阴性。结论HEAML的CT表现有一定特征性,但最终确诊取决于病理及免疫组织化学检查。
Objective To explore the pathological features and CT characteristics of hepatic epithelioid angiomyolipoma (HEAML).Methods Clinical and CT data of 8 HEAML patients confirmed by surgical pathology were retrospectively analyzed.Results All 8 cases were single lesion.5 cases showing inhomogeneous and slightly low density using plain CT scan including 4 cases with small amount of fat,and 1 case with flaky fat.All 8 cases were moderately or significantly inhomogeneous enhanced in arterial phase,including 6 cases with "fast in and slow out",and 2 cases with " fast in and fast out".7 cases had "central vascular sign" in the center and/or periphery of the lesions,and had continuing enhancement in the venous phase.2 cases had " early showing vein" and 3 cases had pseudocapsule.8 cases of melanoma specific antibody 45 (HMB45) positive,6 cases of melanoma antigen (Melan-A) positive,4 cases of smooth muscle actin (SMA) positive,3 cases of S-100 partly positive,2 cases of CD34 positive,8 cases of Ki-67 at different levels (2%-10%),CK,Desmin and alpha fetoprotein (AFP) were all negative.Conclusion HEAML CT presentation has certain characteristics,but the final diagnosis depends on the pathological and immunohistochemical examinations.
作者
赵黎明
路涛
陈光文
李迎春
ZHAO Liming;Lu Tao;CHEN Guangwen;LI Yingchun(Department of Radiology,Sichuan Academy of Medical Sciences/Sichuan ProvincialPeople′s Hospital,Chengdu,Sichuan 610072,China)
出处
《重庆医学》
CAS
2019年第12期2051-2054,2057,共5页
Chongqing medicine
基金
四川省卫生和计划生育委员会科研课题(16PJ463)
