腹腔非肝脏肿瘤^(18)F-FDG PET/CT误诊为肝细胞癌的原因分析  

Extrahepatic tumor originating from the peritoneal cavity misdiagnosed as hepatocellular carcinoma by^(18)F-FDG PET/CT

作　　者：吕文平[1] 贾伟[1] 陈永亮[1] 石怀银[2] 刘长斌[3] 李亚卓[2] 杨莉[1] 许声江[1] 杨磊[1] 

机构地区：[1]解放军总医院海南分院肝胆外科,海南省三亚572013 [2]解放军总医院海南分院病理科,海南省三亚572013 [3]解放军总医院海南分院PET-CT中心,海南省三亚572013

出　　处：《中华普外科手术学杂志（电子版）》2014年第1期36-38,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：国家自然科学基金资助项目(30772493);北京市自然科学基金资助项目(7132191)

摘　　要：目的明确腹腔非肝脏肿瘤18F-FDG PET/CT误诊为肝细胞癌的原因分析。方法通过分析在临床中遇到1例十二指肠肝样腺癌,18F-FDG PET/CT显像误诊为左肝外叶肝细胞癌的病例,结合国内外文献分析与归纳,了解明确腹腔非肝脏肿瘤18F-FDG PET/CT误诊为肝细胞癌的常见临床特征与原因。结果共检索到相关的文献3篇,其中英文文献3篇,中文文献0篇。本组与检索到文献综合分析发现:男2例,女2例,平均年龄66岁,肝内存在病灶误诊2例,肝内无病灶误诊2例。肝样腺癌2例,肝脏炎性假瘤1例,Castleman病1例。其主要原因:(1)定位误差;(2)甲胎蛋白水平升高;(3)存在肝内占位性病变且代谢升高;(4)解剖位置比邻肝脏。结论以选择呼吸门控PET/CT消除定位误差的同时,并结合CT或MRI三期增强扫描检查,可以最大限度地减少腹部病变误诊事件的发生。Objective To analyze the reasons of extrahepatic tumor originating from the peritoneal cavity misdiagnosed as hepatoeellular carcinoma by I^F-FDG PET/CT. Methods A 57-year-old woman referred to our department in 2013 for investigation of a high alphafetoprotein （AFP） level was misdiagnosed as having hepatocellular carcinoma by ISF-FDG PET/CT. After reviwing the articles from Medline, EMBASE, CBMdisc and Wanfang, the reasons for misdiagnosis were suggested. Results Three articles were found from Medline, EMBASE, CBMdisc and Wanfang. All of them were published in English. In 4 patients , 2 were men and 2 women, with a mean age of 66 years （ range from 57 to 79 ）. Two patients had hepatic adenocareinomas, lhad hepatic inflammatory pseudotumor, and lhad Castleman disease. The reasons for the misdiagnosis included： （1） positioning error, （2） high levels of AFP, （3） intrahepatic lesion with significant accumulation of FDG, （4） lesion near to the liver. Conclusions Respiratory gated scan together with triple-phase contrast-enhanced scans by CT or MRI may reduce the occurrence of positioning error and the misdiagnosis.

关 键 词：癌 肝细胞 正电子发射断层显像术 体层摄影术 螺旋计算机 误诊 

分 类 号：R735.31[医药卫生—肿瘤]