摘要
目的总结肝脏血管平滑肌脂肪瘤(hepatic angiomyolipoma,HAML)的临床、影像学及病理学特征,探讨其诊断及治疗方法。方法对2006年4月-2010年4月我院收治的20例HAML患者的临床资料进行回顾性分析。结果 20例患者中男6例,女14例,多无明显临床症状(16/20)。肿瘤长径平均5.25cm。B超多表现为高回声不均质光团(9/13)。大部分患者CT或MRI动态增强扫描表现为动脉期病灶明显强化(19/20),门脉期及延迟期仍持续不同程度的强化。病理结果提示病灶由不同比例的血管、平滑肌细胞及脂肪组成。免疫组化显示HMB45(20/20)、SMA(16/20)表达阳性。CK、AFP均呈阴性。所有病例均经手术切除,随访无复发。结论由于HAML影像学表现多样,HAML术前确诊存在一定困难,最后确诊需依靠病理检查及免疫组化分析。治疗目前仍以手术切除肿瘤为首选,效果良好。
Objective To summarize the clinical, imaging and pathological characteristics of hepatic angiomyolipoma（HAML） and study its diagnosis and treatment methods. Methods Clinical data about 20 hepatic HAML patients（14 females and 4 males） admitted to our hospital from April 2006 to April 2010 were retrospectively analyzed. Results Most of the patients were asymptomatic. The average diameter of the tumor was 5.25cm. Ultrasonography showed heterogeneous light beams with a high echo in most of the patients. CT and MRI demonstrated significantly enhanced lesions in arterial phase and differently enhanced lesions in portal venous and delayed phase, Pathological examination revealed that the lesions were composed of adipose tissue, smooth muscle and blood vessels. Immunohistochemistry displayed that HMB45 and SMA were positively expressed while CK and AFP were negatively expressed in most of the patients. All the patients were followed up after resection of their tumor, during which no relapse occurred. Conclusion It is difficult to establish the diagnosis of HAML because of its various imaging manifestations, and its final diagnosis depends on pathological and immunohistochemical analysis. Surgical resection is the first choice of its treatment.
出处
《军医进修学院学报》
CAS
2012年第9期906-907,919,共3页
Academic Journal of Pla Postgraduate Medical School
