8例原发性肝透明细胞癌的病理特征与影像学误诊分析  

The pathology characteristic and analyze the reason of imaging misdiagnosis for primary clear cell carcinoma of the liver

作　　者：朱达东 林凯 陈海波[2] ZHU Da-dong;LIN Kai;CHEN Hai-bo(Department of Imaging,Yuhuan People's Hospital,Zhejiang Province,Yuhuan Zhejiang,317600,China;不详)

机构地区：[1]浙江省玉环市人民医院影像科,浙江玉环317600 [2]浙江省中医院

出　　处：《中西医结合肝病杂志》2019年第4期357-360,I0006,共5页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

摘　　要：目的:提高对原发性肝透明细胞癌(PCCCL)的影像学和病理学认识水平,降低误诊率。方法:回顾性分析8例经手术病理证实的PCCCL的CT及MRI平扫及增强检查资料,结合文献总结其病理学特性,并分析影像学误诊原因。结果:8例患者10个PCCCL病灶中,男7例,女1例,6例患者8个病灶位于右肝叶,2例各1个病灶位于左肝叶。8例患者中有3例诊断为普通肝细胞癌,2例4个病灶误诊为血管平滑肌脂肪瘤,2例误诊为血管瘤,1例误诊为直肠癌肝转移瘤。免疫组化染色:糖原染色、肝细胞抗原染色8例均为阳性。结论:PCCCL极易误诊,但也有些特点:以男性多见,以右肝叶好发,肿瘤密度低于普通肝细胞癌的密度,内含有脂肪,肿瘤假包膜出现比例较高;糖原染色和肝细胞抗原染色阳性可作为诊断依据。Objective:To improve the knowledge of primary clear cell carcinoma of the liver(PCCCL),decrease the misdiagnosis rate.Methods:CT and MRI finding of 8 patients with PCCCL proved by pathology were analyzed retrospectively,combine with document literature to conclude the pathology characteristic and analyze the reason of imaging misdiagnosis.Results:In 8 cases 10 PCCCL focus nidus,7 males and 1 females,6 cases 8 lesions located in the right liver,2 cases of lesions located in the left liver;3 cases were misdiagnosed as hepatocellular carcinoma,2 cases 4 focus nidus were misdiagnosed as angioleiomyolipoma,2 cases were misdiagnosed as hemangioma,1 case was misdiagnosed as metastasis;Immunohistochemically:tumor cells showed positive for PAS,Hep Parl.Conclusion:PCCCL is easily misdiagnosed,but also some features:clear cell carcinoma of liver in males,right hepatic tumor density was lower than that of the common good hair,hepatocellular carcinoma,which contains fat,appear a higher proportion of pseudocapsule;glycogen staining(PAS)and Sultan III positive staining can be used as a diagnostic basis.

关 键 词：肝透明细胞癌 病理学 误诊 体层摄影术 X线计算机 磁共振成像 

分 类 号：R73[医药卫生—肿瘤]