摘要
目的 总结肝脏血管平滑肌脂肪瘤 (HAML)的临床、影像学及病理学特点以及治疗方法。方法 回顾性分析了 1998年 10月至 2 0 0 3年 1月作者单位手术治疗的 2 6例HAML病人的临床资料。所有病人均行B超、彩色多普勒及CT检查 ,部分病例同时行MRI检查。所有病人均行肝切除术 ,诊断经病理及免疫组化证实并随访至今。结果 2 6例病人中男性 5例 ,女性 2 1例 ,多无明显临床症状。B超多表现为不均质高回声光团 ,彩色多普勒显示点状、短线状彩色血流 ,注射造影剂后显示早期及延迟增强。CT显示动脉期增强 ,门脉期延迟强化。病灶由不同比例的厚壁血管、平滑肌细胞及脂肪混合组成。免疫组化结果HMB4 5 (2 6 / 2 6 )、A10 3(2 4 / 2 6 )和SMA(2 4 / 2 6 )表达阳性。所有病例手术切除随访无复发。结论 多数HAML可经术前影像学检查获得诊断 ,HMB4 5、A10 3和SMA检测有助于确诊。肝切除术治疗HAML可获得满意效果。
Objective To study the clinical, imaging and pathological features and treatment of hepatic aniomyolipoma (HAML). Methods The clinical data of 26 patients with HAML treated in our institute from October 1998 to January 2003 were retrospectively analyzed to determine the clinical, imaging and pathological features of the disease. All the patients received liver resection and were followed up till now. Results There was marked female predominance (21∶5), and most of the patients (18/26) had no symptoms. Most lesions (21/26) showed heterogeneous high echo in ultrasonography and punctiform or filiform vascular distribution pattern in color Doppler sonography. All the 5 lesions further enhanced with Levovist showed early and prolonged enhancement. At contrast-enhanced spiral CT, the soft-tissue components of 24 lesions were markedly enhanced in the arterial phase and 18 remained to be enhanced in the portal venous phase. MRI performed in 9 patients showed hypointensity or hyperintensity on T1-weighted images and heterogeneous hyperintensity on T2-weighted images. Histopathologically, all lesions were composed of adipose tissue, smooth muscle and blood vessels in different proportions. Immunohistochemistry showed that most lesions were positive for HMB45 (26/26), A103 (24/26) and SMA (24/26). Follow-up study showed a benign course and no signs of recurrence. Conclusions Preoperative radiological diagnosis of HAML is possible. The demonstration of intratumoral fat and central vessels is helpful for the diagnosis. HMB45, A103 and SMA are promising markers for pathological diagnosis of HAML. Surgical resection is effective for its treatment.
出处
《中华肝胆外科杂志》
CAS
CSCD
2004年第6期377-379,共3页
Chinese Journal of Hepatobiliary Surgery
