肝巨大血管平滑肌脂肪瘤误诊肝癌1例及文献复习  

Hepatic angiomyolipoma was misdiagnosed as hepatic carcinoma(A case report and literature review)

作　　者：毕方方[1] 计勇[1] 吴志鹏[1] 李清汉[1] 甄作均[1] 

机构地区：[1]佛山市第一人民医院肝脏胰腺外科,广东佛山528000

出　　处：《岭南现代临床外科》2014年第5期523-526,共4页Lingnan Modern Clinics in Surgery

摘　　要：目的探讨肝血管平滑肌脂肪瘤(HAML)的临床特点、病理及免疫组化特征、诊断及其治疗方法,旨在提高临床诊治水平。方法回顾性分析1例于外院误诊为肝癌而于我院经病理证实为肝巨大血管平滑肌脂肪瘤的临床表现、影像学、病理和免疫组化资料并结合文献知识复习。结果 HAML,多好发于女性,多数无明显不适症状。组织学上,肿瘤主要由平滑肌细胞、血管及脂肪3种成分按不同比例混合而成。免疫组化染色显示:瘤细胞对HMB45、Melan-A、SMA表达阳性。结论 HAML临床症状缺乏一定特殊性,影像学检查表现多样,术前容易误诊。诊断不明时建议可行肝穿刺活检以进一步明确性质,确诊有赖于术后病理及免疫组化。Objective To investigate clinical characteristic, pathological and immunohistochmeical features, diagnosis and treatment of hepatic angiomyolipoma （HAML）. Methods One case misdiagn- osed as hepatic carcinoma was retrospectively analyzed and confirmed by pathological examination for huge hepatic angiomyolipoma in our hospital. The clinical presentation, imaging performance, pathological and immunohistochmeical features combining with the knowledge were reviewed. Results Most patients with HAML were asymptomatic, and occur commonly in female. HAML are composed of varying amounts of smooth muscle cells, adipose tissue, and vessels. Immunohistochemeical staining showed the tumor ceils were positive for HMB45, Melan-A and SMA. Conclusion HAML lacks typical clinical presenta tion, its imaging appearance varies widely, easily misdiagnosed as other tumors. Liver biopsy is proposed when it is difficult to get a clear diagnosis. The reliable way to diagnose HAML is depend on pathology and immunohistochemical technique.

关 键 词：肝血管平滑肌脂肪瘤 误诊 肝癌 

分 类 号：R604[医药卫生—外科学]