肝血管平滑肌脂肪瘤的诊断和治疗

目的 研究肝血管平滑肌脂肪瘤（ａｎｇｉｏｍｙｏｌｉｐｏｍａ，ＡＭＬ）临床、影像学、病理学特点，探讨如何降低本病误诊和漏诊率及提高外科疗效。方法 经病理证实的Ａ 。所有病人术前均接受ＣＴ及Ｂ超检查，部分病人还行彩色多普勒、ＭＲＩ及血管造影。术前３全为原发性肝癌，１例为肝脂肪肉瘤，２例为ＡＭＬ，３例为血管瘤。所有病人均行肝切除并随访至今。结果 剖腹探查发现肿瘤大多（６／９）位于右肝，界限清晰，部分肿瘤

DIAGNOSIS AND TREATMENT OF LIVER ANGIOMYOLIPOMA

Objective To study the clinical,imaging and pathological features of liver angiomyolipoma(AML),decrease the possibility of misdiagnosis and discuss the outcome of surgical treatment for patients liver AML with.Methods Nine cases with liver angiomyolipoma which diagnosis was idenfified by pathology were collected for the study.B-ultrasongraphy and dynamic CT examination were carried out for all the patients.MRI,color doppler-sonography (CD-SO) and angiography were also done for some patints.for these patients,the diagnosis of hepatocellular carcinoma was considered in three cases,liposarcoma for one,angiomyolipoma for two,and haemangioma for three,prospectively.Surgical exploration and hepatic resection were performed for all the patients who have been followed up till now. Results Most tumors(6/9)were located in right lobe.All the tumors were well-circumscribed with or without capsulate.Histological observations showed that the tumor was composeal of myoid cells,adipose cells and abnormal thick-walled vessels.Erroneous pathological diagnosis was cocurred in three patients (two was hepatocellular carcinoma and one was hepatocellular adenoma).In all cases,immunohistochemical results showed that the myoid cells were positive for HMB-45. Conclusions Liver angiomyolipoma may be more common than what we have thought before.Many cases would have been misdiagnosed as other liver diseases.Immunohistochemical marker HMB-45 was great value for the diagnosis.For AML patients,surgical resection could get good results.