摘要
目的回顾我院经病理确诊为肝脏血管平滑肌脂肪瘤(HAML)的病例,对其影像学及临床病理特点进行分析,以期提高对HAML的诊断水平。方法收集2000～2011年共8例经我院确诊为HAML的病例,对其临床病理及影象学(包括超声、CT、MRI)检查结果进行分析。结果肿瘤最小直径约1.9cm,最大直径约9.5cm,分为混合型、肌细胞为主型、脂肪细胞为主型和血管瘤型共4型。免疫组化染色:正常肝组织HEP为阳性,HMB45为阴性;8例HMB45、SMA呈弱阳性至强阳性,5例S-100、CD34为阳性,4例Desmin为阳性,CK、EMA、AFP均阴性。8例患者中行超声检查5例,行CT检查5例,行MRI检查4例,仅CT确诊1例。结论 HAML的影像及病理学表现多变,影像科及病理科医师应密切合作以进一步提高诊断水平。由于HAML的术前诊断及鉴别诊断较困难,且有潜在恶变可能,建议手术切除。
Objective To retrospectively analyze the pathological and imaging features of 8 cases of hepatic angiomyolipoma （ HAML ） for improving the diagnostic experience. Methods Eight cases of patients who were diagnosed as HAML during 2000 to 2011 were collected. The pathological and imaging features were analyzed. Results Among the 8 cases, the minimum diameter was 1.9cm and the maximum diameter was 9.5cm. The pathological features of HAML could be divided into 4 groups. As to immunohistochemistry staining, HEP was stained as positive and HMB45 was negative in normal hepatic tissue. 8 cases of HAML were positive to HMBg5 and SMA; 5 cases were positive in S-100 and CD34, 4 cases were positive in Desmin. All the cases were negative in CK, EMA and AFP. Among these cases, 5 cases had ultrasound examination, 5 cases had CT examination and 4 cases had MRI examination. Only 1 case was diagnosed by CT. Conclusion HAML has complicated pathological and image presences. Cooperation between pathologists and radiologists may improve the diagnostic rate of this disease. Because of the difficulty in diagnosis of this disease and its malignant potentiality, surgical treatment of HAML is suggested.
出处
《中国现代医生》
2011年第22期45-47,共3页
China Modern Doctor
