Biecker E, Fischer H P, Strunk H, Sauerbruch T
Medizinische Klinik und Poliklinik I, Universitätsklinikum Bonn.
Z Gastroenterol. 2003 Feb;41(2):191-200. doi: 10.1055/s-2003-37316.
Benign hepatic tumours include a broad spectrum of regenerative and true neoplastic processes. Due to advances in imaging procedures like MRI, Cf-scan and ultrasound as well as progress in immunohistochemistry, the appropriate diagnosis is made ina high percentage of patients without laparotomy and resection. Most important in clinical practice is the differential diagnosis of focal nodular hyperplasia and hepatocellular adenoma because of the risk of rupture and bleeding in the latter. Cavernous haemangioma, the most common benign hepatic tumour, rarely needs treatment. The diagnosis of nodular regenerative hyperplasia is often missed and patients present with secondary complications and signs of portal hypertension that necessitate treatment. The main problem in angiomyolipoma is to distinguish it from malignant processes which do require treatment. Because of its clinical presentation, inflammatory pseudotumour is also sometimes confused with a malignant tumour. Therapeutic options are drug therapy or surgical resection. Benign haemangioendothelioma of the infant is rare but may cause life-threatening complications. Bile duct adenoma is an incidental finding that is not known to cause any symptoms whereas biliary cystadenoma is often symptomatic and may progress to cystadenocarcinoma and therefore needs resection.
良性肝肿瘤包括一系列广泛的再生性和真性肿瘤性病变。由于磁共振成像(MRI)、计算机断层扫描(CT)和超声等成像技术的进步以及免疫组织化学的进展,在无需剖腹手术和切除的情况下,高比例患者能够得到准确诊断。在临床实践中,最重要的是鉴别诊断局灶性结节性增生和肝细胞腺瘤,因为后者存在破裂和出血风险。海绵状血管瘤是最常见的良性肝肿瘤,很少需要治疗。结节性再生性增生的诊断常常被漏诊,患者会出现继发性并发症和门静脉高压体征,需要进行治疗。血管平滑肌脂肪瘤的主要问题是将其与需要治疗的恶性病变区分开来。由于其临床表现,炎性假瘤有时也会与恶性肿瘤混淆。治疗选择包括药物治疗或手术切除。婴儿良性血管内皮瘤罕见,但可能导致危及生命的并发症。胆管腺瘤通常是偶然发现,一般不会引起任何症状,而胆管囊腺瘤通常有症状,可能进展为囊腺癌,因此需要切除。