肝脏血管平滑肌脂肪瘤影像学及临床病理特征分析
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钱建忠 E-mail:shilanli980@yahoo.cn

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Analysis of the imaging and clinicopathological features of hepatic angiomyolipoma
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    摘要:

    目的:分析肝脏血管平滑肌脂肪瘤(hepatic angiomyolipoma,HAML)的影像学、病理学特征以及治疗和预后特点。
    方法:回顾性分析2007—2009年5例HAML患者的临床病理资料。患者均行B超,CT或MRI检查,以肝脏实质性病变入院行肿块及部分肝脏切除术。
    结果:影像学显示肿瘤形态规则、边界清楚。病理结果显示肿瘤均由不同比例的血管、平滑肌、脂肪组成,免疫组化结果HMB45和SMA均阳性表达,经常规病理及免疫组化确诊为HAML。术后6个月至1年随访未见复发及死亡。
    结论:HAML为少见的肝脏肿瘤,肿瘤生物学行为以良性为主,由于其形态学表现多样,容易误诊为恶性,病理医师在诊断时应有HAML的概念,避免误诊。

    Abstract:

    Objective:To study the imaging and clinicopathological features, treatment, and prognosis of hepatic angiomyolipoma (HAML).
    Methods:The clinicopathological data of 5 patients with HAML treated in our haspital from 2007 to 2009 were retrospectively analyzed. All patients underwent excision of hepatic mass or partial liver resection for hepatic parenchymal disease as suggested by B ultrasound, CT or MRI examination.
    Results:The imageological examination showed that the masses exhibited regular shapes and clear margins. Microscopically, the tumors were composed of a mixture of blood vessels, smooth muscle and fat tissues in different proportions. Immunohistochemical staining showed that the tumors were positive for HMB45 and SMA. These tumors were finally comfirmed to be HAML by routine pathological and immunohistochemical diagnosis. No recurrence or death occurred during the half to 1 year periods of postoperative follow-up.
    Conclusions:HAML is a rare tumor of liver and its biological behavior is generally benign. HAML is likely to be misdiagnosed as malignant tumor due to the diverse morphological traits. Pathologists must be aware of the histological findings of HAML to avoid misdiagnosis in their pathological evaluation.

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李世兰| 钱建忠| 徐洪明.肝脏血管平滑肌脂肪瘤影像学及临床病理特征分析[J].中国普通外科杂志,2011,20(7):696-699.
DOI:10.7659/j. issn.1005-6947.2011.07.009

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  • 收稿日期:2011-04-13
  • 最后修改日期:2011-06-24
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  • 在线发布日期: 2011-07-15