肝脏恶性纤维组织细胞瘤2例报告并文献复习

目的:提高对肝脏恶性纤维组织细胞瘤临床诊断的认识。方法:回顾2例经手术和病理检查证实的肝脏恶性纤维组织细胞瘤影像资料,并复习国内相关文献14篇(含18例)。结果:CT和MRI检查:2例肿瘤均位于肝右叶,肿瘤呈浸润性生长,与周围肝实质分界不清。CT平扫表现为不规则形低密度占位,CT值24~40 Hu,增强扫描动脉期肿瘤实质呈不均匀强化。MRI表现为:巨大的占位性病灶,T1WI像为低信号,T2WI像为高信号,信号不均匀,边界不清,形态不规则。动态增强扫描:动脉期、门脉期病灶明显不均匀强化,延迟期强化渐减退或仍见团片状强化。结论:肝脏恶性纤维组织细胞瘤的临床诊断较困难,其影像学表现主要为肿瘤向外浸润生长,边界不清,缺乏特征性征象。

Malignant Fibrous Histiocytoma of Liver.Two Case Report and Literature Review

Objective:To enhance the understanding of the clinical diagnosis of hepatic malignant fibrous histiocytoma(MFH).Methods:2 cases of hepatic malignant fibrous histiocytoma proven by postoperative pathology were examined by means of CT and MRI,and 14 pertinent literatures were reviewed.Results:Tumors of two patients revealed infiltrative growth and were located in the right lobe of the liver.The marginal contours were irregular.On CT,all tumors were hypodense(2440 Hu) on plain scan,and asymmetrical hyper dentisites in parenchyma of mass were seen in arterial phase after contrast injection.On MRI,the main signal intensity of large mass were hypointense on T1WI and hyperintense on T2WI.Asymmetrical signal,and obscure boundary and irregular shape were discovered.On dynamic enhancement scanning,asymmetrical hyper dentisites in parenchyma of mass were showed in arterial and venous phase.On the other hand,the intensification decreased in the majority field and lamellar intensification sustained in partial field in lag period.Conclusion:It is difficult to make right clinical diagnosis of hepatic MFH.The primary imaging character of hepatic MFH is apparently invasive with unclear border.There are not characteristic imaging of MFH.