肺黏膜相关淋巴组织淋巴瘤MSCT表现与病理学基础

目的探讨肺黏膜相关淋巴组织(MALT)淋巴瘤的多层螺旋CT(MSCT)表现特征与病理学表现的关系,提高本病的影像诊断准确性。 方法收集我院17例经病理证实的肺MALT淋巴瘤患者的MSCT及病理资料,15例患者行肺部CT平扫及增强扫描,2例患者仅行肺部CT平扫,结合病理学基础分析其影像学表现特征。 结果17例肺MALT淋巴瘤中,多发5例(5/17),单发12例(12/17),病灶主要分布在支气管血管旁或胸膜下。影像表现为实变形6例(6/17,35%),肿块或结节形7例(7/17,41%),支气管血管束型2例(2/17,12%)混合型2例(2/17,12%)。其中,15例见充气支气管征,10例见血管造影征,9例伴胸腔积液,5例伴支气管扩张,4例伴纵膈淋巴结肿大,2例可见钙化灶,伴肺脓肿、空洞各1例。 结论肺MALT淋巴瘤CT表现以肺实变影、肿块影伴充气支气管征及血管造影征为主要特征,对本病的诊断及鉴别诊断具有重要的提示作用,但确诊需依靠病理活检。     

腹盆腔孤立性纤维瘤影像学表现与病理、免疫组化特征分析

目的探讨腹盆腔孤立性纤维瘤的影像学表现及病理学特征。 方法回顾性分析2015年3月至2021年3月江苏省苏北人民医院经手术病理证实的7例腹盆腔孤立性纤维瘤(SFT)患者的影像学资料，并与病理结果对照。 结果7例SFT患者中男性6例，女性1例；平均年龄57(27~71)岁。1例仅行CT腹部平扫、6例行CT或MRI平扫、增强扫描。1例发生于胰腺，2例位于腹腔，4例位于盆腔。7例中仅1例为多发病灶，其余均为单发，病灶最大径平均值90 mm。CT平扫呈等密度影或伴有稍低密度影，密度均匀或不均匀，其中伴小囊变2例，钙化灶1例。增强扫描仅1例表现为均匀轻微强化，5例动脉期见强化血管影，4例实质期呈"地图样"强化。MRI T1WI呈稍低信号，T2WI呈等低或稍高、稍低混杂信号影，1例病灶见T2WI低信号血管流空影，增强扫描延迟性强化。7例中有2例发生术后转移，1例邻近骨质受侵犯。组织学上SFT主要由梭形细胞和胶原纤维组成，免疫组化主要表现为CD34高表达阳性，Ki-67低表达阳性，恶性SFT表现为CD34表达减弱，而Ki-67高表达。 结论腹盆腔SFT较为少见，其影像学表现具有一定的特异性，且可反映其病理特征，有助于疾病的诊断及鉴别诊断。     

儿童肺结核CT影像分析

目的 探讨儿童肺结核的CT平扫及增强的影像表现特征。 方法 回顾性分析2008年7月至2011年8月在我院住院的69例结核病患儿,临床症状、PPD试验及影像学表现均符合结核病特征,经抗结核治疗后复查,患者临床症状及肺部病灶均有所好转。收集患儿的影像学资料,对其进行分析。 结果 69例患儿的CT不同影像表现为：原发性肺结核（8例）包括原发综合征（5例）和胸内淋巴结结核（3例）,原发综合征表现为肺内的原发结核病灶、结核性淋巴管炎及淋巴结炎,此型与胸内淋巴结结核的CT平扫均可见纵隔、肺门及腋窝多发肿大淋巴结,增强扫描不均匀强化或淋巴结中心干酪坏死区无强化,边缘环形强化的特点。原发性血行播散性肺结核（10例）表现为两肺大小、密度、分布均匀一致的粟粒状影合并纵隔淋巴结肿大。原发性肺内浸润性结核病灶和干酪性肺炎（43例）的影像表现为2个肺叶散在分布的结节状、斑片状影,还有甚至双肺多叶多段广泛分布的结核病灶,在结节状、斑片状、大片状结核病灶的基础上形成干酪性肺炎、空洞。结核性胸膜炎（8例）可见不同程度的渗出性胸腔积液及胸膜增厚粘连等表现。 结论 CT平扫及增强对于诊断儿童肺结核,明确肺内各种病灶形态,轻微病灶、隐匿病灶、微结节及干酪性肺炎等具有一定价值,可为临床诊断提供重要依据。     

原发性肺肉瘤样癌的CT影像学特征

目的 探讨原发性肺肉瘤样癌的CT影像征象及临床表现,提高对该疾病的认识.方法 回顾性分析2011年1月至2020年9月我院15例经病理证实的原发性肺肉瘤样癌的临床资料及CT影像征象.结果 15例原发性肺肉瘤样癌患者中,多见于50岁以上有吸烟史的中老年男性,临床表现以咳嗽、咳痰及痰中带血多见.CT上肺内肿瘤均单发,病变位...     

4例原发性肝脏神经内分泌肿瘤临床分析及文献复习

目的 总结原发性肝脏神经内分泌肿瘤(PHNEN)患者的病例资料,分析其临床特征,以提高临床诊断和治疗水平。方法 回顾性分析、总结我院诊治PHNEN患者的临床表现、化验检查、影像学特点、病理学检查和治疗转归。结果 4例患者均为女性,中位年龄为56(40,73)岁;2例无不适主诉,2例有腹痛;血清ALT 28.3(18.0～49.8)U/L,TBIL 11.5(9.5～16.3)μmol/L,神经元特异性烯醇化酶(NSE)为44.1(20.2～77.1)ng/ml;腹部CT均提示肝内多发占位,增强扫描动脉期呈环形或不均匀强化,静脉期强化程度降弱;组织病理学检查示3例为神经内分泌癌,1例为神经内分泌瘤G2;1例患者接受对症治疗,采取手术、介入和/或药物等联合治疗另3例患者,随访11～81个月,2例死亡,2例生存。结论 PHNEN临床少见,缺乏特征性临床表现、辅助检查和病理学诊断标志,需排除其他病变后方可考虑诊断。早期发现和联合治疗是改善患者预后的重要策略。     

Multiple Nodular lesions In Spleen Associated With Visceral Leishmaniasis: A Case Report of MRI-Findings

The spleen is one of the most commonly involved organs of visceral leishmaniasis (VL). However, there were few reports about imaging findings of splenic leishmaniasis, especially regarding MRI findings.This case report describes a 45 years old male patient from Zhejiang province of southeastern China, who was admitted for persistent fever of unknown origin, with splenomegaly and multiple hypodense/low echo nodules on CT/ultrasonography (USG) studies. MRI showed multiple nodules with concentric rings in the spleen on T2-weighted imaging (T2WI), with no obvious diffusion restriction on diffusion weighted imaging (DWI), and gradual ring-like enhancement after intravenous administration of contrast medium. So MRI suggested necrotic granulomatous lesion. By reviewing the clinical history and following positive serological leishmania antibody test, the patient was finally confirmed a recent infection with VL.The patient received antimony gluconate therapy intravenously.At 4 months follow-up, the contrast-enhanced abdominal MRI showed that the size of the spleen was returned to normal and the splenic lesions were completely resolved except for reduced infarction compared with the previous MRI.This is the first case which was performed MRI examination completely. Meanwhile, it is the second case which MRI findings were reported. As for the characteristics of MRI in this case, there are several features, which are helpful for giving the diagnosis and differential diagnosis of VL.     

Littoral cell angioma presenting as metastatic thyroid carcinoma to the spleen.

Papillary thyroid carcinoma (PTC) commonly metastasizes to cervical lymph nodes. Distant metastases are unusual with the lungs most frequently involved. Well-differentiated thyroid carcinoma very rarely presents with metastases to the spleen. This is the case of a 25-year-old man with a history of PTC (1.4 cm primary; no capsular invasion and negative lymph node metastases). One year after initial surgery, recurrent disease was found in multiple neck nodes by central neck dissection. Whole body scan (WBS) following a therapeutic ablation dose of 150 mCi I(131) revealed mediastinal metastases. Computerized axial tomography (CT) of the chest one year later showed no gross mediastinal or pulmonary disease. However, multiple large splenic lesions were incidentally noted. Evaluation by ultrasound (US) showed lesions to be solid echogenic masses without remarkable Doppler characteristics to suggest vascular tumors. US-guided percutaneous fine-needle aspiration biopsy (FNAB) of one lesion was nondiagnostic. After withdrawal from Levothyroxine, serum TSH was >100 mU/L with a thyroglobulin of 9.4 ng/mL and negative anti-thyroglobulin antibodies. Diagnostic WBS revealed faint splenic uptake but was otherwise unremarkable. Following treatment with 192 mCi I(131), WBS demonstrated increased activity in the mediastinum as well as in the spleen suggesting mediastinal and splenic metastases. Contrast CT of the abdomen showed multiple low-attenuated heterogeneously enhancing splenic masses, normal liver and no intra-abdominal lymphadenopathy. The largest mass (4.5 x 3.5 cm) was exophytic and in close proximity to the splenic capsule. Despite the serum thyroglobulin of only 9.4 ng/mL, the finding of I(131) accumulation within solid splenic masses led to a preoperative diagnosis of thyroid carcinoma metastases. To establish the diagnosis and to remove the risk for splenic rupture, a laparoscopic splenectomy was performed. Histopathologic analysis showed large littoral cell angiomas (LCA). False-positive radioiodine scintigraphy in the setting of PTC involving a vertebral hemangioma has been reported. To our knowledge, this is the first case that describes multiple angiomas mimicking metastatic thyroid carcinoma to the spleen. In one-third of all cases reported, LCA co-exists with various visceral organ cancers or malignant lymphoma. This is the first report of an association between LCA and thyroid carcinoma.     

非功能性胰腺神经内分泌瘤的CT表现

目的分析非功能性胰腺神经内分泌肿瘤的多排螺旋CT表现。 方法收集2003年5月至2015年6月解放军第404医院经临床和手术病理确诊为非功能性胰腺神经内分泌肿瘤且术前在本院行上腹部增强CT检查的患者15例。回顾性分析其多排螺旋CT图像,主要观察肿瘤的数目、位置、形状、大小、密度及强化方式等。 结果15例均为胰腺单发肿瘤,发生于胰体部7例、头部5例、尾部3例。肿瘤呈圆形或类圆形,平均直径3.8 cm。CT平扫11例表现为稍低密度影,2例表现为等密度,2例表现为囊性病灶。增强后3例表现为等密度强化,6例为低密度强化,5例为高密度强化,1例囊性病灶无强化。5例可见胰管扩张,肝转移瘤见于1例患者,增强后呈环形强化。 结论非功能性胰腺神经内分泌肿瘤的多排螺旋CT表现具有一定特点,但其鉴别诊断较难,需结合影像学表现和临床信息判断。     

Primary splenic epithelioid hemangioendothelioma with diffuse metastases revealed by FDG PET/CT imaging: A case report

Rationale:Epithelioid hemangioendothelioma (EHE) is a rare low-to-intermediate grade malignant vascular neoplasm. We report a primary splenic EHE with diffused metastasis who underwent ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT). Our case emphasizes that EHE should be considered a differential diagnose of ¹⁸F-FDG-avid splenic malignancies.Patient concerns:A 39-year-old man presented with abdominal distension and chest distress for 20 days and lumbago for 2 days. Transthoracic echocardiography suggested a large amount of pericardial effusion. Contrast-enhanced CT imaging showed splenomegaly with multiple low-density nodules with ring enhancement. A large irregular mass was also found in the right superior mediastinum with heterogeneous density and enhancement. ¹⁸F-FDG PET/CT imaging revealed splenomegaly, filled with intense hypermetabolic nodules and masses. And multiple regions of increased ¹⁸F-FDG uptake were observed in the mediastinum, left pleura, and bones.Diagnosis:EHE of the spleen.Interventions:Half a month after the diagnosis was confirmed, the patient then underwent chemotherapy, Docetaxel combined with carboplatin, and Endu were administrated every 3 weeks.Outcomes:During the 6-month follow-up period, the patient has finished 4 cycles of chemotherapy combined with 2 months of targeted drug. Efficacy assessment is partial remission through CT imaging, and clinical symptoms of patient improved significantly.Lessons:Primary splenic EHE is extremely rare, especially with diffuse systemic metastasis. Our report suggested that EHE should be considered a differential diagnosis of ¹⁸F-FDG-avid splenic malignancies. Furthermore, ¹⁸F-FDG PET/CT plays critical role in staging and accessing disease extent of EHE.     

原发性肺滑膜肉瘤诊断与治疗附1例报告及文献复习

目的 通过探讨原发性肺滑膜肉瘤的临床症状、影像学表现、病理学及免疫组化,提高对本病的认识.方法 报告近期呼吸科确诊1例原发性肺滑膜肉瘤患者,同时对既往报道18例患者进行回顾性研究,分析其临床表现、影像学表现、病理学特征及免疫组化特点.结果 临床表现为咳嗽、咳痰或胸痛、胸闷等,影像学表现为肺部肿块影,边缘清楚或呈分叶状,病灶密度不均匀,增强扫描呈不均匀强化,可伴纵隔淋巴结肿大及胸腔积液,病理学检查提示为梭形细胞恶性肿瘤,瘤细胞呈流水状排列,核分裂象易见,免疫组化EMA、Bcl-2、Vimentin等阳性.结论 原发性肺滑膜肉瘤临床表现及影像学表现上无特异性,不易与其他肺或胸膜原发性肉瘤相鉴别,需要结合病理及免疫组化结果进行诊断.     

Clinical features and spiral computed tomography analysis of undifferentiated embryonic liver sarcoma in adults

OBJECTIVE: To summarize the clinical and spiral computed tomography (CT) features of undifferentiated embryonic liver sarcoma (UELS) in adults. METHODS: Clinical and CT findings of four adult patients with pathology‐approved UELS were retrospectively analyzed with a literature review. All patients were examined using a plain and enhanced spiral CT scan. RESULTS: The participants were two men and two women with a mean age of 36.5 years. The clinical manifestations were the right upper quadrant mass, pain (n= four) and intermittent fever (n= three). Laboratory tests showed a mild elevation of alpha‐fetoprotein in one patient and mildly abnormal liver function in two. Liver cirrhosis was present in one patient coexistent with hepatocellular carcinoma. CT findings indicated a huge well‐defined cystic‐solid mass with varying degrees of enhancement of the solid component. Irregular high‐density lesions showing hemorrhage occurred in three patients and the inferior vena cava was compressed in one. CONCLUSION: UELS showed a solitary and predominantly cystic or multicystic appearance on CT imaging compared with ultrasound (US) from the medical literature, which shows a predominantly hypoechoic mass. The laboratory tests were normal or mildly abnormal despite the presence of the large mass. The combination of these clinical features and CT findings together with those of US are helpful in making a prospective diagnosis.     

MRI长时间延迟增强扫描诊断肝脏孤立性坏死性结节价值研究*

目的 探讨磁共振成像（MRI）长时间延迟增强扫描诊断肝脏孤立性坏死性结节（SNNL）的价值。方法 2013年5月~2018年5月我院就诊的17例SNNL患者和15例肝脏恶性肿瘤患者（其中10例为肝细胞癌和5例为肝转移癌）,所有患者均行常规CT/MRI增强扫描及MRI多期长时间延迟至120 min扫描,分别比较两组病灶影像学特征,如病灶密度、强化类型,探讨长时间延迟扫描在鉴别SNNL与肝脏恶性肿瘤中的作用。结果 在SNNL患者,CT和MRI共检出17个病灶,均位于肝右叶,且均为单发病灶,直径为（2.1±0.4） cm;在10例HCC患者,MRI检查发现11个病灶,位于肝右叶者8个,位于肝左叶者3个。单发病灶9例,多发病灶1例,直径为 （5.4±1.6） cm;在5例肝脏转移癌患者中,共检出12个病灶,位于肝右叶者9个,位于肝左叶者3个,直径为 （3.1±0.9）cm;在SNNL病灶中有4个病灶在T2WI上表现为“靶征”,与肝转移癌病灶的影像学表现类似;在延迟期（DP）3/5 min扫描,HCC和肝转移癌病灶边缘多呈中度-重度环形强化,SNNL病灶边缘强化水平随着延迟时间延长而逐渐增强。在DP 1 h时,17个病灶均表现为中度-重度环形强化,病灶中心无强化,而肝脏恶性肿瘤病变边缘强化均已消失。结论 MRI 长时间延迟增强扫描能有效区分SNNL与肝脏恶性肿瘤,主要表现为在延迟扫描时呈病灶边缘和间隔环形强化,且病变中心无强化。     

肾结核CT检查的临床意义

目的 探讨CT检查对肾结核患者的临床意义。方法 回顾性分析42例肾结核患者的CT及临床资料（其中16例有IVP结果）。结果 单侧肾结核34例，双侧8例，即患肾共50个。典型CT表现有肾实质内围绕肾盂排列的多个囊状低密度区相邻肾皮质变薄（34／50），肾盂输尿管管壁增厚及管腔扩张积水（22／50），肾实质钙化（8／50）。不典型表现有肾实质内单或多发直径小于1cm左右略低于密度结节（6／50）。30例增强CT扫描示，患肾有不同程度强化，其CT上升值在20－120HU之间。腹腔大量淋巴结钙化者2例；合并肝、脾结核4例；腰椎结核骨质破坏并椎旁肿肿6例；合并后腹壁结核脓肿1例。结论 CT检查不仅可用于肾结核的诊断，同时可明确患肾功能、破坏程度、患肾周围情况以及是否合并腹腔其它脏器结核，为临床提供更多更有价值的参考资料。     

胸部CT扫描显示簇状微结节样病灶对肺结核的诊断价值

目的 探讨胸部CT扫描显示簇状微结节样病灶对肺结核的诊断与鉴别诊断价值。方法 回顾性分析2016年1月至2019年8月北京胸科医院行CT扫描表现为簇状微结节样病灶并诊断明确的患者74例。其中70例患者经临床或实验室检查诊断为活动性肺结核,2例诊断为非特异性炎症,2例诊断为结节病。本研究重点分析其中70例诊断为肺结核患者的CT扫描特征,包括簇状微结节样病灶的分布部位、分布方式、形态特征,以及并存的肺内其他形态病变的CT征象。 结果 70例肺结核患者胸部CT扫描显示,簇状微结节样病灶分布于双肺上叶尖后段49例(70.0%),多发者49例(70.0%)。CT表现为均匀样、晕征样、反晕征样、混合存在等4种表现形式,分别占47.1%(33/70)、25.7%(18/70)、18.6%(13/70)及8.6%(6/70)。病灶内结节大小均匀29例(41.4%),大小不等、有融合41例(58.6%)。肺内簇状微结节样病灶之外,伴有其他肺野并存病灶表现为1种形态(实变、空洞、结节样病灶、纤维条索状病灶四种形态之一)者10例(14.3%),2种形态者15例(21.4%),3种形态者16例(22.9%),4种形态者6例(8.6%);纵隔和(或)肺门淋巴结肿大者14例(20.0%),胸腔积液9例(12.9%)。2例结节病和2例非特异性炎症也表现为簇状微结节样病灶,与肺结核的影像特征近似。结论 CT扫描表现为簇状微结节样病灶,无论是单发局限性或是多发性分布,均应首先考虑是继发性肺结核的一种较常见的不典型表现形式,值得重视。     

A case of hepatosplenic cat scratch disease]

A 43-year-old man was admitted with idiopathic fever. Abdominal ultrasonogram demonstrated multiple hypoechoic lesions in the spleen. Abdominal CT scan showed multiple hypodense lesions in the liver and spleen. The patient had a cat in his house, and the presence of a very high serous antibody titer for Bartonella henselae led to the diagnosis of hepatosplenic cat scratch disease. It is important to consider this disease in the differential diagnosis of idiopathic fever when multiple lesions are detected in the liver and spleen.     

肺硬化型血管瘤CT表现与病理对照

目的分析肺硬化型血管瘤(PSH)CT影像特点,提高对PSH诊断水平。方法收集经病理证实为PSH患者11例,全部病例均作胸部CT平扫及增强扫描,并对靶病灶进行薄层多方位重建,分析CT表现,总结影像学特点。结果 11例PSH,CT平扫均表现为肺内孤立性圆形、类圆形结节或肿块影,密度均匀,边缘光滑,无深分叶,增强扫描病灶均明显强化。病理以血管瘤样及乳头样组织结构为主者,强化明显而迅速;以实性及硬化性组织结构为主者,为渐进性明显均匀强化。结论肺硬化型血管瘤少见,CT表现具有一般良性肿瘤特征,但缺乏特异性,病灶周边出现"贴边血管征"、"空气新月征"可提示性诊断,确诊仍需病理学检查。     

A case report of abdominal splenosis - a practical mini-review for a gastroenterologist

Splenosis is a benign condition caused by ectopic autotransplantation of splenic tissues after splenic trauma or surgery. It is usually diagnosed accidentally. However, occasionally splenosis poses a significant diagnostic dilemma, especially when this condition presents as a metastatic malignant disease on abdominal imaging. This is the case report of a 54-year-old woman, who underwent post-traumatic splenectomy at the age of 12 years. The physical examination of this patient complaining of epigastric and low back pain, except for postoperative abdominal scar, as well as laboratory tests were normal. Esophagogastroduodenoscopy showed chronic gastritis. Abdominal ultrasound revealed no spleen, enlarged lymph nodes in the right retroperitoneum and a focal lesion in the uterus. In addition, the CT scan disclosed enlarged left hepatic lobe, numerous oval tumors between intestinal loops, in the caecal region, under the diaphragm and abdominal wall, periaortic enlarged lymph nodes and an osteolytic lesion in the first lumbar vertebra, suggesting disseminated malignant disease. The exploratory laparotomy showed multiple abdominal nodules, a tumor of the ileum, the greater omentum and the uterus. Except for the last one (leiomyoma), all excised tumors proved to have histological structure typical for the spleen and, finally, abdominal splenosis was diagnosed. Splenosis should be considered when a differential diagnosis of tumor-like lesions disclosed on abdominal imaging occurs in a patient with a splenic injury in the past.     

Multiple cavitary pulmonary metastases from ovarian cancer: a case report]

Cavitation in pulmonary metastases is thought to be uncommon. To date, few cases of pulmonary metastases originating from ovarian cancer and showing cavitation have been reported. We report a patient with multiple cavitation in pulmonary metastases from ovarian mucinous cystadenocarcinoma. A 28-year-old woman was admitted to our hospital presenting with cough and fever. The patient had undergone right ovariectomy for ovarian mucinous cystadenocarcinoma at the age of 23 years. Her chest radiograph on admission showed multiple cavities associated with infiltration in both lungs. Histological sections obtained by transbronchial lung biopsy revealed mucus-secreting adenocarcinoma, and a diagnosis of metastatic lung cancer from the ovary was made. Computed tomographic (CT) scans of the chest demonstrated various findings, including multiple thick-walled cavities, thin-walled cavities, air-space consolidations, ground glass opacities, and centrilobular nodular shadows formed by aspiration of the mucinous secretions. It is important to recognize that cavitation can occur in pulmonary metastases from ovarian cancer.     

局灶性机化性肺炎40例误诊分析

目的探讨局灶性机化性肺炎(FOP)的临床表现、病理学特征和影像学特点,以提高临床医师对本病的认识。方法回顾性分析2013-2018年江苏省人民医院住院手术切除的40例误诊为肺癌的FOP患者的临床资料,对其临床表现、病理学特征、影像学特点、实验室检查等综合分析。结果(1)40例FOP患者中,男34例,女6例,年龄范围为26~82岁,平均年龄(55.55±10.52)岁。(2)临床表现中,咳嗽咳痰21例,发热6例,咯血8例,胸痛12例,体检发现14例。(3)病变在肺野外、中、内带及各肺叶均有发生。CT表现多样,除结节影和实变影外,合并有分叶状、边缘毛刺征、支气管充气征、空泡征、密度不均、胸膜牵拉等。病灶范围≥3 cm的26例,<3 cm的14例。(4)共有8例患者行PET-CT检查,其中6例患者均有不同程度氟代脱氧葡萄糖代谢增高,提示恶性病变可能;2例未见氟代脱氧葡萄糖代谢增高,考虑炎症后改变。(5)40例患者中,癌胚抗原、糖类抗原199均正常,仅有1例神经元特异性烯醇化酶轻度增高,D-二聚体均正常。(6)病理提示间质纤维组织增生,肺泡腔扩张,腔内见纤维素样黏液栓形成,间质多量淋巴细胞浸润伴淋巴滤泡形成。(7)40例手术患者中,1例患者半年后复查手术缝线周围复发;余复查均正常。结论FOP临床相对少见,因其特殊影像表现极易误诊。临床医师需不断加强对FOP的认识,通过基本信息、临床特征、影像、实验室检查、病理特征等综合诊断,以减少临床误漏诊。     

Hepatic epithelioid hemangioendothelioma: Dilemma and challenges in the preoperative diagnosis

Hepatic epithelioid hemangioendothelioma (HEHE) is a rare category of vascular tumor with uncertain malignant potential. It commonly presents nonspecific and variable clinical manifestations, ranging from asymptomatic to hepatic failure. In addition, laboratory measurements and imaging features also lack specificity in the diagnosis of HEHE. The aim of the present study is to highlight the dilemma and challenges in the preoperative diagnosis of HEHE, and to enhance awareness of the range of hepatobiliary surgery available in patients with multiple hepatic nodular lesions on imaging. In these patients, HEHE should at least be considered in the differential diagnosis.