肝脏血管周上皮样细胞肿瘤影像及临床特征  

Imaging and clinical features of hepatic perivascular epithelioid cell tumor

作　　者：余传林 冯湘[1] 陈瑶[1] 刘宇[2] 贺亚琼 YU Chuan-lin;FENG Xiang;CHEN Yao(Department of Radiology,the First Affiliated Hospital of Hunan Normal University(Hunan Provincial People’s Hospital),Changsha 410005,China)

机构地区：[1]湖南师范大学附属第一医院(湖南省人民医院)放射科,长沙410005 [2]湖南师范大学附属第一医院(湖南省人民医院)病理科,长沙410005

出　　处：《放射学实践》2023年第3期295-299,共5页Radiologic Practice

基　　金：长沙市科技计划项目(kq1907062)。

摘　　要：目的:探讨肝脏血管周上皮样细胞肿瘤(PEComa)的影像表现及临床、病理特点,提高对该病的认识及诊断水平。方法:回顾性分析湖南省人民医院2014年11月-2021年3月经病理证实的50例肝脏PEComa患者的影像表现、临床及病理资料。结果:50例患者中,女39例,男11例。肿块常单发,边界清晰,密度不均,以肝右叶多见。动态增强扫描动脉期明显强化,强化方式多样,以持续性强化多见。肝胆特异期呈低信号。部分病灶可见脂肪、假包膜及增粗血管。肿瘤多为良性,较少累及临近结构,术后复发少见。免疫组织化学结果显示,Melan-A、SMA、Ki-67指数阳性表达率90%以上,CD34、CD31和S-100部分表达。结论:肝脏PEComa的影像及病理具有一定的特点,对该病的诊断及鉴别诊断有重要价值。Objective:To investigate the imaging,clinical,and pathological features of hepatic perivascular epithelioid cell tumors(PEComa).Methods:The imaging,clinical and pathological data of 50 patients with hepatic PEComa confirmed by pathology in The People's Hospital Hunan Province from November 2014 to March 2021 were retrospectively analyzed.Results:There were 39 female and 11 male patients.The lesions tend to be solitary mass in the right lobe with demarcated margin and substantial heterogeneity.Dynamic enhancement imaging showed avid enhancement in the arterial phase,with persistent enhancement in majority,and hypointensity on hepatobiliary phase.Intratumoral fat,capsule and enlarged vessels may exist.As benign tumor,hepatic(PEComa)rarely demonstrated adjacent structures invasion and postoperative recurrence.Immunohistochemistry showed that positive expression rate of over 90%for SMA,Melan-A and Ki-67 index,and partially expression of CD34,CD31 and S-100.Conclusion:Imaging and pathology characteristics may be valuable for diagnosis and characterization of hepatic PEComa.

关 键 词：血管周上皮样细胞肿瘤 计算机断层扫描 磁共振成像 肝脏 

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]