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儿童未分化胚胎性肝肉瘤:临床特征及免疫组化分析

Childhood undifferentiated embryonal liver sarcoma: clinical features and immunohistochemistry analysis.

作者信息

Wei Zhong Gu, Tang Lan Fang, Chen Zhi Min, Tang Hong Fang, Li Min Ju

机构信息

Department of Pathology, The Children's Hospital of Zhejiang University School of Medicine, 57 Zhugan Xiang, Hangzhou 310003, China.

出版信息

J Pediatr Surg. 2008 Oct;43(10):1912-9. doi: 10.1016/j.jpedsurg.2008.06.016.

Abstract

PURPOSE

The aim of the study was to report on 3 cases of childhood undifferentiated embryonal liver sarcoma (UELS) and to highlight the clinical features, laboratory findings, diagnosis, and management of this rare disease.

METHODS

The patients' age, sex, clinical features, laboratory findings, pathologic results, and therapy were reviewed. Immunohistochemistry analysis was performed on the resected mass sections.

RESULTS

In this study, 2 cases were female (aged 8 and 12 years) and 1 was male (aged 9 years). The causes of hospitalization were mainly abdominal pain, mass, or fever. An elevated erythrocyte sedimentation rate was noted in 2 available cases, and alpha fetoprotein (AFP) was within the normal range. Imaging findings indicated a well-defined heterogeneous large mass in the right lobe. Histopathologic evaluation of the mass confirmed the diagnosis of UELS. Immunohistochemical staining showed that vimentin and CD68 antigen were positive in all samples, whereas desmin was positive in one sample. Surgery with chemotherapy was performed in 2 cases.

CONCLUSION

The diagnosis of UELS depends mainly on the pathologic findings. Undifferentiated embryonal liver sarcoma should be included in the differential diagnosis of mass in the liver, especially with well-defined heterogeneous imaging findings and normal AFP. Diagnosis and management should be made early as UELS is a potentially treatable tumor.

摘要

目的

本研究旨在报告3例儿童未分化胚胎性肝肉瘤(UELS)病例,并强调这种罕见疾病的临床特征、实验室检查结果、诊断及治疗方法。

方法

回顾了患者的年龄、性别、临床特征、实验室检查结果、病理结果及治疗情况。对切除肿块的切片进行了免疫组织化学分析。

结果

本研究中,2例为女性(年龄分别为8岁和12岁),1例为男性(9岁)。住院原因主要是腹痛、肿块或发热。2例可获取病例的红细胞沉降率升高,甲胎蛋白(AFP)在正常范围内。影像学检查结果显示右叶有一个边界清晰的异质性大肿块。肿块的组织病理学评估确诊为UELS。免疫组织化学染色显示,波形蛋白和CD68抗原在所有样本中均呈阳性,而结蛋白在一个样本中呈阳性。2例患者接受了手术及化疗。

结论

UELS的诊断主要依赖于病理检查结果。未分化胚胎性肝肉瘤应纳入肝脏肿块的鉴别诊断,尤其是具有边界清晰的异质性影像学表现且AFP正常的情况。由于UELS是一种潜在可治疗的肿瘤,应尽早进行诊断和治疗。

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