肝血管平滑肌脂肪瘤的影像学表现及其诊断(附3例报道)  

Hepatic Angiomyolipoma:CT Manifestations and Clinicopathologic Correlation(Report of 3 Cases)

作　　者：路涛[1] 周翔平[2] 姜兴莲[3] 刘翔[3] 

机构地区：[1]四川省医学科学院.四川省人民医院放射科,成都610072 [2]四川大学华西医院放射科,成都610041 [3]四川省医学科学院.四川省人民医院病理科,成都610072

出　　处：《中国普外基础与临床杂志》2010年第8期860-864,共5页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨肝血管平滑肌脂肪瘤(HAML)的CT表现及相关临床特点。方法回顾性分析3例经手术病理确诊的HAML患者的临床、CT及病理资料,分析其影像学表现及特点。结果 3例患者均为女性,其中2例有腹痛表现,1例无任何症状。2例实验室检查均正常,1例除乙肝标志物(+)外,其余正常。CT表现:肿瘤位于肝右叶前上段1例,右叶后下段1例,左内叶1例;肿块内可见脂肪成分及软组织成分,其中脂肪成分CT值为-80～-20HU(平均-50HU);增强后均有不同程度强化,可见强化血管影。术中见均为外生性包块。免疫组化染色HMB-45(+)、α-SMA(+)、S-100(+),符合血管平滑肌脂肪瘤的诊断。结论 HAML是一种少见的良性肿瘤,其影像学表现有一定特征性,确诊有赖于免疫组化检测HMB-45。Objective To investigate the CT imaging features of hepatic angiomyolipoma and its clinical characteristics. Methods The clinical,radiological,and pathological data of 3 hepatic angiomyolipoma （HAML） patients were retrospectively collected,and the imaging and diagnostic features were analyzed. Results All 3 cases were females,2 complained of abdominal pain and one was absent of symptom. Both the laboratory examinations were normal in 2 cases,and hepatitis B virus markers were positive in one case. For CT features,the mass located in the superior anterior segment of the right hepatic lobe,in the posterior inferior segment of the right hepatic lobe,and in the left medial lobe,respectively. There were components of fat and soft tissue attenuation in these masses,and in which the CT value of the fat component was from-80 HU to-20 HU （mean-50 HU）. There were enhancement in different degree and enhanced vascular imaging could be seen within the lesions. During surgery,all 3 masses were outgrowed from the hepatic lobes. Immunostainning showed HMB-45 （＋）,α-SMA （＋）,S-100 （＋）,which were strongly suggestive of HAML. Conclusion HAML is a rare benign tumor with characteristic CT appearance,and its definite diagnosis relies on the immunohistochemical staining of HMB-45.

关 键 词：肝脏 血管平滑肌脂肪瘤 断层摄影术 X线计算机 HMB-45 

分 类 号：R735.7[医药卫生—肿瘤] R814.4[医药卫生—临床医学]