Ichikawa T, Takayasu K, Tochihara M, Oohira M, Moriyama N, Terui S, Muramatsu Y, Nawano S, Terauchi T, Sekiguchi R
Nihon Igaku Hoshasen Gakkai Zasshi. 1991 Oct 25;51(10):1224-31.
From January 1976 to October 1989, 15 patients with hepatoblastoma who underwent surgery at the National Cancer Center Hospital were evaluated by clinico-radiological techniques. Eight patients were boys and seven were girls; their average age was 3 years and 5 months. Abdominal mass or distention was initially noted in 12 patients. Alpha-fetoprotein level was extremely high (average, 327 micrograms/ml) in all cases but one. Hepatitis B surface antigen was negative in all cases. Tumors occupied mainly the right lobe of the liver in 67% of patients, and the mean tumor diameter was 11.1 cm. Of 15 hepatoblastomas, 10 were grossly classified as massive type and five as multinodular. Histopathological diagnosis was well differentiated (fetal type) hepatoblastoma in 10 patients and poorly differentiated (embryonal type) hepatoblastoma in five. Fibrous capsule was also recognized in eight. The noncancerous liver was normal in all cases. Ultrasonography (US) (n = 7 patients) demonstrated an inhomogeneous internal echo with well demarcated margin in five cases and without such margin in two. Nonenhanced CT (n = 6) showed an isodense or low density mass in all cases. Drip infusion CT (n = 5) revealed isodensity in the early phase. Dynamic CT performed in one patient showed a well enhanced mass that appeared hypervascular on angiography. Preoperative chemotherapy and radiation therapy provoked histological changes such as necrosis, fibrosis and calcifications. These changes were reflected on CT images. Both US and CT demonstrated the characteristic internal structure and gross appearance of hepatoblastoma.
1976年1月至1989年10月，对在国立癌症中心医院接受手术的15例肝母细胞瘤患者采用临床放射学技术进行评估。8例为男孩，7例为女孩；平均年龄为3岁5个月。12例患者最初表现为腹部肿块或腹胀。除1例患者外，所有病例的甲胎蛋白水平都极高（平均为327微克/毫升）。所有病例的乙肝表面抗原均为阴性。67%的患者肿瘤主要占据肝脏右叶，平均肿瘤直径为11.1厘米。15例肝母细胞瘤中，10例大体分类为巨块型，5例为多结节型。组织病理学诊断为10例患者为高分化（胎儿型）肝母细胞瘤，5例为低分化（胚胎型）肝母细胞瘤。8例还可见纤维包膜。所有病例的非癌肝脏均正常。超声检查（US）（7例患者）显示，5例内部回声不均匀，边界清晰，2例边界不清晰。平扫CT（6例）在所有病例中均显示等密度或低密度肿块。滴注CT（5例）在早期显示等密度。1例患者进行的动态CT显示肿块强化明显，血管造影显示为高血供。术前化疗和放疗引起了坏死、纤维化和钙化等组织学改变。这些改变在CT图像上有所体现。超声和CT均显示了肝母细胞瘤的特征性内部结构和大体外观。
