8例肝脏上皮样血管平滑肌脂肪瘤的病理表现及CT特征研究  

Pathological features and CT characteristics of 8 cases of hepatic epithelioid angiomyolipoma

作　　者：赵黎明[1] 路涛[1] 陈光文[1] 李迎春[1] ZHAO Liming;Lu Tao;CHEN Guangwen;LI Yingchun(Department of Radiology,Sichuan Academy of Medical Sciences/Sichuan ProvincialPeople′s Hospital,Chengdu,Sichuan 610072,China)

机构地区：[1]四川省医学科学院/四川省人民医院放射科

出　　处：《重庆医学》2019年第12期2051-2054,2057,共5页Chongqing medicine

基　　金：四川省卫生和计划生育委员会科研课题(16PJ463)

摘　　要：目的探讨肝脏上皮样血管平滑肌脂肪瘤(HEAML)的病理表现及CT特征。方法回顾性分析8例经手术病理证实的HEAML患者的临床及CT资料。结果8例均为单发病灶,5例CT平扫为不均匀稍低密度,4例含少量脂肪,1例含丰富的斑片状、片状脂肪。动脉期呈不均匀明显或中等强化,6例呈"快进慢出",2例呈"快进快出"。7例病灶中心和(或)周边出现"中心血管征",且静脉期持续强化。2例出现"静脉早显",3例出现假包膜。8例人黑色素瘤特异性抗体45(HMB45)阳性,6例黑素-A(Melan-A)阳性,4例平滑肌动蛋白(SMA)阳性,3例S-100部分阳性,2例CD34阳性,8例Ki-67不同程度表达(2%~10%),CK、Desmin及甲胎蛋白(AFP)均为阴性。结论HEAML的CT表现有一定特征性,但最终确诊取决于病理及免疫组织化学检查。Objective To explore the pathological features and CT characteristics of hepatic epithelioid angiomyolipoma (HEAML).Methods Clinical and CT data of 8 HEAML patients confirmed by surgical pathology were retrospectively analyzed.Results All 8 cases were single lesion.5 cases showing inhomogeneous and slightly low density using plain CT scan including 4 cases with small amount of fat,and 1 case with flaky fat.All 8 cases were moderately or significantly inhomogeneous enhanced in arterial phase,including 6 cases with "fast in and slow out",and 2 cases with " fast in and fast out".7 cases had "central vascular sign" in the center and/or periphery of the lesions,and had continuing enhancement in the venous phase.2 cases had " early showing vein" and 3 cases had pseudocapsule.8 cases of melanoma specific antibody 45 (HMB45) positive,6 cases of melanoma antigen (Melan-A) positive,4 cases of smooth muscle actin (SMA) positive,3 cases of S-100 partly positive,2 cases of CD34 positive,8 cases of Ki-67 at different levels (2%-10%),CK,Desmin and alpha fetoprotein (AFP) were all negative.Conclusion HEAML CT presentation has certain characteristics,but the final diagnosis depends on the pathological and immunohistochemical examinations.

关 键 词：肝脏 上皮样 血管平滑肌脂肪瘤 体层摄影术 X线计算机 

分 类 号：R445.3[医药卫生—影像医学与核医学]