DIAGNOSIS AND TREATMENT OF HEPATIC ANGIOMYOLIPOMA_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

黄刚 ¹ , 马曾辰 ² , 钦伦秀 ² , 孙惠川 ² , 汤钊猷 ² , 张连海 ² , 张建平 ²

Corresponding author：

Keywords：

血管平滑肌脂肪瘤肝脏 B超 CT MRI 病理学肝切除

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

目的报告8例肝血管平滑肌脂肪瘤的影像学特征及病理学特点，探讨其诊断与治疗方法。方法对8例经手术及病理证实的肝血管平滑肌脂肪瘤的术前影像学表现（B超、CT、MRI、99mTcPMT）、手术情况及病理特点进行分析。结果B超：肿瘤呈强回声光团6例，低回声光团2例；边界清楚7例，血供丰富、内部回声不均匀4例，其中1例内部呈分隔网状结构。彩色Doppler超声示肿瘤血供丰富，均测及动脉频谱，阻力指数为0.4～0.5。静脉造影示肿瘤内血流信号明显增加。CT：平扫示肿瘤呈低密度影7例，不均匀5例，边界清楚7例，肿瘤内见软组织影2例，脂肪成分2例。增强扫描示动脉期明显强化，门脉期及延迟期逐渐呈低密度。MRI: 肿瘤呈短T1、长T2信号，增强后强化明显，脂肪抑制后短T1变成长T1。99mTcPMT示肿瘤呈放射性增强，5 min相肿块区呈放射性缺损，2 h、5 h延迟相肿块区未见放射性填充，肝血池相肿块呈放射性填充。病理及免疫组化：肿瘤由成熟的脂肪、血管及平滑肌组成，HMB45阳性。术前确诊3例。结论B超示强回声光团，CT呈低密度影中出现软组织影、脂肪成分，增强明显，MRI出现脂肪信号，脂肪抑制后短T1变成长T1，增强明显。99mTcPMT示肿瘤呈放射性增强，5 min相呈放射性缺损，延迟相未见放射性填充，肝血池相呈放射性填充。这些是肝血管平滑肌脂肪瘤的影像学特点，结合病史可作出诊断。此病应尽早手术治疗，行肝部分切除术。最后确诊依靠病理检查及免疫组化分析。

Citation： 黄刚,马曾辰,钦伦秀,孙惠川,汤钊猷,张连海,张建平. DIAGNOSIS AND TREATMENT OF HEPATIC ANGIOMYOLIPOMA. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2002, 9(6): 439-440. doi: Copy

1.	Chang JC, Lee YW, Kim HJ. Preoperative diagnosis of angiomyolipoma of the liver [J]. Abdom Imaging, 1994; 19(6)∶546.
2.	Ahmadi T, Itai Y, Takahashi M, et al. Angiomyolipoma of the liver: significance of CT and MR dynamic study [J]. Abdom Imaging,1998; 23(5)∶520.
3.	Tsui WM, Colombari R, Portmann BC, et al. Hepatic angiomyolipoma: a clinicopathologic study of 30 cases and delineation of unusual morphologic variants [J]. Am J Surg Pathol， 1999; 23(1)∶34.
4.	蔡中琼，黄刚. 多发性子宫肌瘤合并肝血管平滑肌脂肪瘤1例 [J]. 国际中华临床医学杂志，2001; 2（2～3）∶147.
5.	Nonomura A, Minato H, Kurumaya H. Angiomyolipoma predominantly composed of smooth muscle cells:problems in histological diagnosis [J]. Histopathology， 1998; 33(1)∶20.
6.	Nonomura A, Mizukami Y, Takayanagi N, et al. Immunohistochemical study of hepatic angiomyolipoma [J]. Pathol Int，1996; 46(1)∶24.
7.	Messiaen T, Lefebvre C, Van Beers B, et al. Hepatic angiomyo(myelo)lipoma: difficulties in radiological diagnosis and interest of fine needle aspiration biopsy [J]. Liver，1996; 16(5)∶338.
8.	Yeh HC,Klion FM.Angiomyolipoma: ultrasonographic signs of lipomatous Hepatic tumor [J].J Ultrasound Med，1996; 15(4)∶337.
9.	Murakami T, Nakamura H, Hori S, et al. Angimyolipoma of the liver. Ultrasound, CT, MRI imaging and angiography [J]. Acta Radiol，1993; 34(4)∶392.
10.	Ukai K, Fuji A, Nishiwaki J, et al. Giant hepatic angiomyolipoma associated with disseminated intra vascular coagulation [J]. Intern Med，1997; 36(3)∶186.

1. Chang JC, Lee YW, Kim HJ. Preoperative diagnosis of angiomyolipoma of the liver [J]. Abdom Imaging, 1994; 19(6)∶546.
2. Ahmadi T, Itai Y, Takahashi M, et al. Angiomyolipoma of the liver: significance of CT and MR dynamic study [J]. Abdom Imaging,1998; 23(5)∶520.
3. Tsui WM, Colombari R, Portmann BC, et al. Hepatic angiomyolipoma: a clinicopathologic study of 30 cases and delineation of unusual morphologic variants [J]. Am J Surg Pathol， 1999; 23(1)∶34.
4. 蔡中琼，黄刚. 多发性子宫肌瘤合并肝血管平滑肌脂肪瘤1例 [J]. 国际中华临床医学杂志，2001; 2（2～3）∶147.
5. Nonomura A, Minato H, Kurumaya H. Angiomyolipoma predominantly composed of smooth muscle cells:problems in histological diagnosis [J]. Histopathology， 1998; 33(1)∶20.
6. Nonomura A, Mizukami Y, Takayanagi N, et al. Immunohistochemical study of hepatic angiomyolipoma [J]. Pathol Int，1996; 46(1)∶24.
7. Messiaen T, Lefebvre C, Van Beers B, et al. Hepatic angiomyo(myelo)lipoma: difficulties in radiological diagnosis and interest of fine needle aspiration biopsy [J]. Liver，1996; 16(5)∶338.
8. Yeh HC,Klion FM.Angiomyolipoma: ultrasonographic signs of lipomatous Hepatic tumor [J].J Ultrasound Med，1996; 15(4)∶337.
9. Murakami T, Nakamura H, Hori S, et al. Angimyolipoma of the liver. Ultrasound, CT, MRI imaging and angiography [J]. Acta Radiol，1993; 34(4)∶392.
10. Ukai K, Fuji A, Nishiwaki J, et al. Giant hepatic angiomyolipoma associated with disseminated intra vascular coagulation [J]. Intern Med，1997; 36(3)∶186.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

DIAGNOSIS AND TREATMENT OF HEPATIC ANGIOMYOLIPOMA

Abstract Full text Figures/Tables Video References Cited by

Format

Content