肝脏间叶性错构瘤的病理与CT表现  

Pathological and CT manifestations of mesenchymal hamartoma of the liver

作　　者：袁世俊[1] 李金凝 彭海腾[1] 蔡静[1] 刘欢欢[1] 张财源[1] 汪登斌[1] YUAN Shijun;LI Jinning;PENG Haiteng;CAI Jing;LIU Huanhuan;ZHANG Caiyuan;WANG Dengbin(Department of Radiology,Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院放射科

出　　处：《中国医学物理学杂志》2019年第9期1029-1033,共5页Chinese Journal of Medical Physics

基　　金：国家重点研发计划（子课题）（2017YFC0109003）

摘　　要：目的:探讨肝脏间叶性错构瘤(MHL)在儿童与成人的临床、病理与CT表现。方法:回顾性分析2013年1月至2019年5月经病理证实的6例MHL中7个病灶的临床、病理与CT资料,分析并总结其特征表现。结果:本组病例包含5例儿童(中位年龄1岁)与1例成人(年龄65岁),其中成人病例含2个病灶。5例儿童MHL均位于肝脏右叶,其中4例MHL表现为双房或多房囊性,囊液密度均匀;1例病灶为囊实性,囊内见液平影;囊壁无强化或轻至中度强化。1例成人MHL的2个病灶分别位于肝脏左、右叶,均为实性,病灶在CT上呈稍低密度,增强后较大病灶主体无强化、局部轻度延迟强化,较小病灶呈轻度延迟强化。儿童MHL镜下见纤维组织将疏松水肿的间叶组织分隔成囊腔,可见小胆管增生及血管。成人MHL镜下见增生、变性的胶原纤维、散在分布的肝细胞岛与畸形的血管和胆管。结论:MHL的临床、病理及CT表现在儿童与成人间具有一定共性与差异,对MHL的临床诊断具有一定意义。Objective To investigate the clinical,pathological and CT manifestations of mesenchymal hamartoma of the liver(MHL)in children and adults.Methods The clinical,pathological and CT data of 7 lesions in 6 cases of MHL confirmed by pathology from January 2013 to May 2019 were analyzed retrospectively.Moreover,the characteristic representations were analyzed and summarized.Results A total of 5 children(median age,1 year)and a 65 year-old adult who had 2 lesions were enrolled in the study.All the MHL in 5 children were located at the right lobe of the liver.The MHL in 4 children were double or multilocular cystic,with homogeneous cystic fluid,and the MHL in the other 1 case was cystic-solid,with non-uniform liquid density in the cyst,without enhancement or mild to moderate enhancement in the cystic wallin the cyst.Cystic walls showed no enhancement or mild to moderate enhancement.The 2 MHL lesions in the adult were located at the left and right lobes of the liver respectively,and both of which were solid.The lesions showed a slightly lower density on CT.After enhancement,the majority of the larger lesions had no enhancement,except local slightly and delayed enhancement,and the smaller lesions had slightly and delayed enhancement.Pathologically,the mesenchymal tissues with loose edema were separated into cysts by fibrotic tissues,and hyperplastic bile ducts and blood vessels were observed in pediatric MHL.Microscopically,adult MHL was characterized by hyperplastic and degenerative collagen fibers,with scattered liver cell islands,malformed blood vessels and bile ducts.Conclusion There were commonalities and differences in the clinical,pathological and CT findings of MHL in children and adults,which may be helpful for the clinical diagnosis of MHL.

关 键 词：间叶性错构瘤 肝脏 儿童 CT 

分 类 号：R814.42[医药卫生—影像医学与核医学] R735.7[医药卫生—放射医学]