肝血管平滑肌脂肪瘤2例报告

肝脏血管平滑肌脂肪瘤（Hepatic angiomyolipoma，HAML）属少见病，我院2003-04／2005-04收治2例，现复习文献报告如下。     

肝血管平滑肌脂肪瘤一例

患者男 ,6 8岁。 1991年体检时Ｂ超发现左肝有一直径 2ｃｍ的肿块 ,诊断为“血管瘤” ,无不适 ,亦未经任何治疗。1999年因胸背部带状疱疹复查Ｂ超 ,左肝示 7.6ｃｍ× 7ｃｍ× 8.1ｃｍ强光团 ,界尚清 ,内部略不均匀 ,印象为左肝血管瘤。ＣＴ检查发现左肝内侧段有 6 .9ｃｍ× 6 .7ｃｍ肿块 ,表面隆起 ,其内密度不均 (3.3～ 5 1Ｈｕ) ,强化至 83Ｈｕ ,动脉期病灶内可见较粗条状血管影 ,边缘灶强化 ,界较清。因ＣＴ印象首先考虑血管平滑肌脂肪瘤 ,于 1999年 9月 13日住院行左肝肿块切除术。体检 :体温 37°Ｃ、脉搏 80次 /ｍｉｎ、呼吸 2 0次 /…     

肝血管平滑肌脂肪瘤一例报道

肝血管平滑肌脂肪瘤属罕见肿瘤,到1993年为止国外文献报道仅36例,国内尚未见报道。我院通过B超、CT、病理检查及手术,诊疗了一例肝血管平滑肌脂肪瘤,报道如下。 临床资料 彭某,男,50岁,因右上腹隐痛不适,自己扪     

肝血管平滑肌脂肪瘤1例报道

血管平滑肌脂肪瘤(Angiomyolipoma,AML)为少见病,多见于肾脏,发生在肝脏者罕见且成分复杂,术前诊断困难,因此,误诊率较高.作者通过1例较典型的肝血管平滑肌脂肪瘤完整病例的介绍及相关文献复习,以期提高对肝血管平滑肌脂肪瘤的认识及诊断水平.     

肝上皮样血管平滑肌脂肪瘤2例

目的:探讨肝上皮样血管平滑肌脂肪瘤的病理诊断及鉴别诊断.方法:收集武钢总医院病理科2007-2009年手术切除肝上皮样血管平滑肌脂肪瘤标本2例,对2例肝上皮样血管平滑肌脂肪瘤相关临床资料、病理学特征及免疫组织化学进行观察分析并复习相关文献.结果:2病例均为女性,巨检境界较清楚,镜下见肿瘤主要由弥漫的上皮样细胞构成,排列...     

肝血管平滑肌脂肪瘤的影像学征象

肝血管平滑肌脂肪瘤(HAML)顾名思义主要由血管、平滑肌和脂肪3种成分组成,典型的结构为分化不同阶段的平滑肌样细胞与脂肪细胞的相混杂,点缀着畸形的血管.肾脏血管平滑肌脂肪瘤多见,发生于肝脏者极少.     

吲哚菁绿荧光成像实时导航肝占位切除术中探测肝血管平滑肌脂肪瘤1例报告

<正>无肝硬化背景患者的单发肝结节常因难以鉴别良恶性而影响治疗方式的选择。肝血管平滑肌脂肪瘤(hepatic angiomyolipoma,HAML)的影像学表现与肝恶性肿瘤极为相似,但二者预后不同,临床需明确鉴别诊断。现将吲哚菁绿荧光成像实时导航肝占位切除术中发现1例HAML病例报道如下。     

肾血管平滑肌脂肪瘤17例临床分析

1994年1月~2006年1月我院,共收治肾血管平滑肌脂肪瘤(AM L)患者17例,现回顾性分析如下。临床资料:本组17例AM L患者,男7例,女10例;年龄24~69岁。肿瘤位于左侧10例,右侧6例,双侧1例。有症状7例(血尿1例,腰腹部疼痛4例,包块2例),余均在健康查体B超检查时偶然发现。无破裂出血及家     

肾血管平滑肌脂肪瘤21例报告

肾血管平滑肌脂肪瘤属良性还是恶性,至今尚无统一认识。我院于1957～1989年共收治21例,本文对其形态学特点、病理分级、临床诊断及治疗等进行讨论分析。一、临床资料本组年龄24～73岁;病程3天至15年。     

肝血管平滑肌脂肪瘤的MRI及临床病理特征

目的探讨肝血管平滑肌脂肪瘤(hepatic angiomyolipoma,HAML)的MRI表现及临床病理特征。方法回顾性分析经病理证实的9例HAML的MRI特征及临床表现。结果 9例均为单发肿块,中位直径4.0 cm(1.4~15.3 cm)。7例无不适症状,2例上腹部不适,均行手术切除,中位随访10个月(2~24个月),无复发。组织学上分为混合型4例和肌瘤型5例。免疫组化均HMB-45(+)、SMA(+)、CD34(+)。5例MRI回波序列见大量脂质成分。增强MRI分两种类型:Ⅰ型,动脉期明显强化,门脉期和延迟期仍强化(混合型和肌瘤型各1例),其对应病理为肿瘤组织含较少血管;Ⅱ型,动脉期强化,门脉期和延迟期消退,其病理为肿瘤富含血管(混合型3例及肌瘤型4例)。结论 HAML临床表现无特异性,HAML的增强MRI特征与肿瘤组织富含血管多少有关。确诊需病理及免疫组化检测HMB-45、SMA、CD34阳性。     

Angiomyolipoma of the liver: A collective review

This review summarizes the clinical and pathological findings of 52 cases of hepatic angiomyolipoma to discern and establish the most pertinent clinical and pathologic characteristics of the tumor. The disease was symptomatic in 60% of the patients. Abdominal pain or distress was the most common symptom, appearing in 37% of the patients, followed by malaise and upper abdominal mass or hepatomegaly. Of the 52 patients, only three (5.8%) showed associated tuberous sclerosis. Antemortem diagnosis of the tumor has been made with increasing frequency with the recent advent of computed tomography (CT) and ultrasound (US). The tumor was usually visualized as a hyperechoic mass by US imaging and as a low density mass less than -20 Housefield units by CT, and was hypervascular on angiography. The tumor was usually yellow to light tan, depending on the amount of fat tissue. Histologically, the tumor was characterized by an admixture of mature fat cells, blood vessels, and smooth muscle cells, with occasional foci of extramedullary hematopoiesis. The aumount of smooth muscle component varied and often exhibited hypercellularity, pleomorphism with occasional bizarre giant cells, and moderate mitotic activity. These features are considered conducive to an erroneous diagnosis of malignant tumor. However, since no malignant counterpart has been reported, it can easily be accurately differentiated histologically, if one is aware of the entity and can identify the three components of the tumor; blood vessels, smooth muscle cells, and fat. With regard to the histogenesis of angiomyolipoma, primitive mesenchymal cells around blood vessels may be the precursor cells.     

Angiomyolipoma of the liver: Its clinical and pathological diversity

Eighty cases (82 tumors) of hepatic angiomyolipoma (AML) from the world literature were reviewed, including our 8 cases. The tumors occurred predominantly in females (female: male ratio, 56∶24). Only six patients (7.5%) had associated tuberous sclerosis. The majority of the tumors (95%) occurred in non-cirrhotic, almost normal liver. The tumors usually presented as a hyperechoic mass on ultrasound (US) examination, a hypodense mass on computed tomography (CT) scan, and hyperintense mass on both T1- and T2-weighted magnetic resonance (MR) imagings. However, the imaging features of the tumor were occasionally variable according to the content of fat tissue component, and the tumors could not be clearly differentiated from other hepatic tumors, particularly hepatocellular carcinoma (HCC), based on the imaging features alone. Tumor location was recorded in 81 tumors; 44 were located in the right lobe, 30 in the left, 5 in the caudate, and 2 in both lobes of the liver. The tumor diameter ranged from 0.3 to 36cm (mean, 8.0±7.0cm). Macroscopically, the tumors usually had no fibrous capsule. The cut surface was yellow to dark brown depending on the amount of fat tissue or blood vessels. The histologic features were quite variable and occasionally included atypical and/or pleomorphic cells, which could lead to the erroneous diagnosis of a variety of benign and malignant tumors, including lipoma, leiomyoma, HCC, hepatoblastoma, leiomyosarcoma, and malignant fibrous histiocytoma. Extramedullary hematopoiesis was found in 33% of the tumors. Reactivity of the tumor cells of the liver with HMB-45, a melanoma-specific antibody, can accurately establish the diagnosis of AML.     

巨大肝血管瘤1例

肝血管瘤是肝脏最常见的良性肿瘤,目前其发病机制尚未明确.肝血管瘤临床表现无特异性,影像学检查对其诊断有重要意义,是否需要治疗及如何治疗主要根据病人的具体情况而定.     

Angiomyolipoma of the liver: Case report and collective review of cases diagnosed from fine needle aspiration biopsy specimens

We experienced a rare case of primary angiomyolipoma (AML) of the liver, preoperatively diagnosed by fine needle aspiration biopsy (FNAB). Radiographic imaging revealed characteristic features of an angiomyolipoma. The diagnosis was confirmed by the presence of epithelioid smooth muscle cells, mature fat cells and blood vessels in the biopsy tissue. Our review of the literature showed this to be the eleventh case to be diagnosed in this way. Despite this preoperative diagnosis, the lesion was resected because of its pleomorphic histological features. Histologically, the epithelioid smooth muscle component included cells with a bizarre appearance and occasional hyperchromatic nuclei, and furthermore, occasional mitotic figures were observed. In own MEDLINE search of the literature we found 11 cases of AML of the liver for which the diagnoses were established by FNAB, and the same features were present in 5 cases for which surgical excision was contemplated.     

Colonic Angiomyolipoma

Abstract: Angiomyolipoma is a rare benign tumor which usually occurs in the kidney with tuberous sclerosis. We encountered a case of angiomyolipoma of the cecum not associated with tuberous sclerosis. To our knowledge, this is only the third case reported in the international literature.     

肝脏巨大血管平滑肌脂肪瘤1例报告并文献复习

正1病例资料患者女性,20岁,因"间断腹部不适1年"入院。查体:皮肤、巩膜无黄染,未见肝掌、蜘蛛痣,全身浅表淋巴结未触及肿大,双侧肺呼吸音清,心律齐,全腹可触及弥漫性肿块,大小约18 cm×10 cm,质中,活动度差,无压痛,双下肢无水肿。腹部彩超:上腹部见实性低回声区,形态欠规则,边界与网膜分界欠清,范围164 mm×90 mm。彩色多普勒血流显像(color Dppler     

Primary malignant liver mesenchymal tumor: a case report

Primary malignant liver mesenchymal tumor is a rare condition defined as a tumor with vascular, fibrous, adi-pose, and other mesenchymal tissue differentiation. We report a case of primary malignant liver mesenchymal tumor in a 51-year-old male with anemia, weight loss and hepatomegaly. Finally unconventional liver biopsy and histological manifestation led to the definitive diag-nosis.     

先天性血色病1例

血色病是指铁过量沉积于肝脏、胰腺、心脏及其他实质器官,并对这些器官的结构和功能造成损害的疾病。多发生于北欧人,而亚洲人和黑人发病率较低,在我国发病少见。现将我科收治1 例血色病患者的临床资料报道如下。     

血缘性活体部分肝移植术:附1例报告

目的报告1例血缘性活体部分肝移植术的临床体会。方法受体为12岁女童,诊断为先天性肝纤维化,供体为患儿的父亲,手术方式为切取供体肝脏的左半肝,并原位移植给患儿。术后进行了严格的监护治疗。结果供肝手术历时540分钟,切取肝脏450g,术后恢复顺利。受体手术历时685分钟,出血1400ml,无肝期80分钟,移植肝脏热缺血时间为0,冷缺血时间30分钟。术后采用FK506、晓悉及皮质激素行免疫抑制治疗,术后2月各项生化指标正常。结论活体部分肝移植术技术要求高。良好的肝外科及血管外科技术及术后管理是确保肝移植术成功的关键。     

Presumed primary malignant melanoma of the liver: a case report

A 55-year-old woman was hospitalized with a palpable and painful mass in her upper abdomen. Abdominal computed tomography revealed a 10 × 7-cm tumor extending into the abdominal cavity from the left hepatic lobe and multiple metastatic lesions in the right hepatic lobe. A left hepatic lobectomy was performed for debulking and palliative resection. Histopathological examination of the resected specimen diagnosed the large hepatic tumor in the left hepatic lobe as a malignant melanoma. Physical and radiological examinations were performed on dermatological, ophthalmic, gynecological, and central nervous system areas, and endoscopic examinations were performed on the upper digestive tract and colon. No other lesions were disclosed as possible primary tumors for the disease. This result suggested that the tumor might arise from the left hepatic lobe.