| 摘要: |
| ［摘要］ 目的 探讨肝脏上皮样血管平滑肌脂肪瘤（HEAML）的影像学与病理特征。方法 选择四川省肿瘤医院2012-09～2019-09经手术病理证实的15例HEAML患者的临床资料，总结其影像学与病理特征。结果 15例HEAML平扫均呈稍低密度/信号，边界清楚，5例病灶内见少许脂肪成分。增强扫描动脉期15例均呈明显不均匀强化，其内含丰富强化血管，呈斑片、结节样状强化，门脉期及延迟期11例仍持续强化，相对周围肝实质呈“快进慢出”强化方式，4例呈“快进快出”强化方式。4例可见畸形引流静脉，1例可见假包膜。镜下均可见上皮样肿瘤成分及不同比例的脂肪样细胞、厚壁血管组成，免疫组化15例黑色素标志物HMB45、Melan-A及平滑肌标志物平滑肌肌动蛋白（SMA）阳性，肌酸激酶（CK）、S-100、肝细胞抗原（Hep Par 1）、甲胎蛋白（AFP）均阴性。结论 HEAML有一定的特征性影像表现，肿瘤内丰富强化血管、畸形引流静脉等有助于诊断，但确诊往往依赖于病理检查。 |
| 关键词: 肝脏上皮样血管平滑肌脂肪瘤 影像学表现 病理特征 |
| DOI：10.3969/j.issn.1674-3806.2021.04.06 |
| 分类号:R 575 |
| 基金项目:四川省医学科研青年创新课题计划项目（编号：Q18004） |
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| CT and MRI and pathological features of hepatic epithelioid angiomyolipoma |
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LIANG Xu, YAN Jia-xin, DENG He-ping, et al.
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Department of Radiology, Sichuan Cancer Hospital, Chengdu 610041, China
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| Abstract: |
| ［Abstract］ Objective To investigate the imaging manifestations and pathological features of hepatic epithelioid angiomyolipoma(HEAML). Methods The clinical data of 15 HEAML patients confirmed by surgery and pathology in Sichuan Cancer Hospital from September 2012 to September 2019 were selected, and their imaging and pathological characteristics were summarized. Results A clear boundary lesion and slightly lower density/signal were showed in the 15 cases of HEAML receiving plain scans. A small amount of fat composition was observed in the lesions of 5 cases. In the arterial phase of the enhanced scan, obvious inhomogeneous contrast was showed in the 15 cases, including enriched and enhanced blood vessels, patchy or nodular-like enhancement. In the portal vein phase and delayed phase, 11 lesions had a continuous enhancement with the characteristics of “fast-in and slow-out” enhancement mode relative to the surrounding liver parenchyma, 4 lesions with “fast-in and fast-out” enhancement mode, 4 lesions with deformed drainage veins, and 1 lesion with pseudocapsules. Epithelial tumor components, fat-like cells of different proportions, and thick-walled blood vessels could be seen under the microscope, and the immunohistochemistry features of all the 15 lesions showed positive melanin markers human melanoma black(HMB45) and melanoma-antigen(Melan-A), and smooth muscle marker smooth muscle actin(SMA), and negative creatine kinase(CK), S-100, hepatocyte(Hep Par 1), and alpha-fetoprotein(AFP). Conclusion HEAML has some characteristic imaging manifestations. The characteristics of enriched and enhanced blood vessels and deformed drainage veins in the tumor are helpful for diagnosis, while the confirmed diagnosis still highly depends on pathological examination. |
| Key words: Hepatic epithelioid angiomyolipoma(HEAML) Imaging manifestations Pathological features |
