摘要
目的:探讨肝脏炎性假瘤(inflammatory pseudotumor,IPT)的临床特点与治疗问题.方法:总结病理证实的18例IPT的临床、病理、影像学、实验室检查及随访资料并结合相关文献进行回顾性分析.结果:18例IPT的主要症状为右上腹隐痛(11/18),术前检查3例血白细胞增高[(11.8～12.7)×109/L],7例肝功能轻度异常,2例甲胎蛋白超过25 μg/L.B超多表现为不均质低回声结节,CT平扫病灶呈低密度,增强后病灶可不强化或不同程度强化.手术疗效确切,手术后无并发症,术后随访无复发.结论:肝脏炎性假瘤临床上有一定特点,但仍易与原发性肝癌混淆,建议结合临床和实验室检查以及多项的影像学资料以提高诊断率,诊断不明或不能排除肝癌者建议手术治疗.诊断明确者可进行保守治疗或局部治疗.
Objective:To study the clinical features and treatment of inflammatory pseudotumor(IPT) in the liver. Methods:Eighteen patients with IPT conformed by pathology were studied retrospectively. The clinical, pathological, follow-up data were analyzed and related literatures were reviewed. Results:The main manifestation in 18 patients with IPT was dull pain of the right upper abdomen. Preoperative laboratory examinations showed increased white blood cell count in 3 patients[(11.8～12.7)×109/L],slightly abnormal liver function in 7 patients and AFP level>25 μg/L in 2 cases. Ultrasonography demonstrated inhomogeneous low echogenic lesions. IPT appeared as low density lesions at non-enhanced CT scan, which was enhanced for various degrees or even did not enhance with contrast medium. The outcome was satisfactory with surgical removal with no postoperative complications or relapses. Conclusion:Although IPT has some clinical features, it remains difficult to be differentiated from primary hepatocellular carcinoma(PHC).Combination of clinical manifestations, laboratory examination and imaging investigation can help to increase the accuracy of diagnosis. Surgical treatment is recommended when the diagnosis is in doubt or PHC can not be excluded. Conservative therapy or radiologic intervention remains the optimal management when IPT can be confirmed.
出处
《新医学》
北大核心
2005年第7期391-392,共2页
Journal of New Medicine
