肉瘤样肝细胞癌的CT表现与临床病理特征  

CT and clinical pathological characteristics of sarcomatoid hepatocellular carcinoma

作　　者：刘日敏 张晴荣 钟百书[2] 李振伟[2] 

机构地区：[1]浙江省苍南县人民医院放射科,浙江温州325800 [2]浙江大学医学院附属第一医院放射科,浙江杭州310003

出　　处：《医学影像学杂志》2010年第1期63-66,共4页Journal of Medical Imaging

摘　　要：目的:探讨肉瘤样肝细胞癌(SHC)临床CT表现和病理特征,提高对此病的认识。方法:对经病理证实的6例SHC的CT和临床资料进行回顾性分析。结果:5例患者均有上腹部胀痛及发热,但血常规提示WBC计数正常,HBsAg均为阳性,血清AFP不高,无肝硬化基础。全部患者均表现为肝内直径3～11cm的囊实质性肿块,其中右肝4例,左肝1例,4例边缘清楚,2例边界不清。CT平扫见2例密度均匀,4例密度不均匀,内有液化坏死或纤维化及钙化;增强CT上1例呈均匀强化,4例呈不均匀轻至中度强化,1例不强化,>6cm的肿瘤呈肿瘤内条片状强化。2例可见门脉癌栓形成。结论:SHC因具有肝细胞癌及肉瘤的双重成分在临床病理与CT特征而具一定特征性,对本病定性诊断有价值。Objective：To investigate the value of computed tomography （CT） in the diagnosis of sarcomatoid hepatocellular carcinoma （SHC） correlated with the pathological findings.Methods：Tile CT and clinical data of all 6 cases of pathologically proved SHC were reviewed retrospectively. Results：5 patients were males and 1 patient female, with a mean age of 43 years. They underwent upper abdomen pain and fever, Laboratory test showed a normal count of WBC and positive HBsAg. AFP was normal, 6 had no liver cirrhosis. All cases presented with a spheroid solid hepatic mass ranged from 3 to 11 cm in diameter （average 7 cm） .4 lesions in right lower lobe, 1 in left lobe. Among 6 cases： 4 cases had clear margin and 2 hadn＇t. Two massess were homogenous in density,and the other 4 were inhomogeneous in density with formation of central cavity or calcification. After intravenons contrast administration, one lesion showed homogeneous enhancement, and the other 4 lesions had inhomogencons enhancement. The lesions with diameter larger than 6 crn showed marginal or patch-like enhancement. Cancer embolus in the portal vein was displayed in 2 out of the 6 patients. Corlclusion：There are some relatively specific featuresof SHC on CT, which may be helpful for diagnosis.

关 键 词：肉瘤样肝细胞癌 体层摄影术 X线计算机 临床 病理学 

分 类 号：R735.7[医药卫生—肿瘤] R814.42[医药卫生—临床医学]