Pathology Division, National Cancer Center Hospital, Tokyo, Japan.
Surg Today. 2010 Sep;40(9):883-9. doi: 10.1007/s00595-010-4255-7. Epub 2010 Aug 26.
A 52-year-old woman presented with upper abdominal pain. Abdominal ultrasonography showed a 4-cm well-defined mass containing solid and cystic components in segment IV of the liver, and contrast-enhanced T1-weighted magnetic resonance imaging revealed heterogeneous enhancement within the tumor, indicating a solid or fibrous component. There were no cystic lesions in any other organs. A partial hepatectomy was performed, based on a preoperative diagnosis of sclerosing hemangioma and biliary cystadenoma or cystadenocarcinoma. Pathologically, the tumor appeared to be a multilocular and cystic lesion lined by attenuated endothelial- like cells with no atypia. Immunohistochemistry demonstrated the endothelial-like cells to be positive for the lymphatic-specific markers D2-40, LYVE-1, and Prox-1, which proved helpful for confirming the diagnosis as solitary hepatic lymphangioma. This case is presented with details of the pathologic and radiologic findings, because solitary hepatic lymphangioma is an extremely rare tumor and no previous reports have provided details of the immunohistochemical characteristics.
一位 52 岁女性因上腹痛就诊。腹部超声显示肝脏 IV 段有一个 4cm 大小的边界清楚的肿块,包含实性和囊性成分,增强 T1 加权磁共振成像显示肿瘤内呈不均匀强化,提示存在实性或纤维性成分。其他器官均无囊性病变。根据术前诊断为硬化性血管瘤、胆管囊腺瘤或囊腺癌,行部分肝切除术。病理上,肿瘤呈多房囊性病变,由无异型性的萎缩内皮样细胞排列。免疫组化显示内皮样细胞淋巴管特异性标志物 D2-40、LYVE-1 和 Prox-1 阳性,有助于确诊为孤立性肝淋巴管瘤。本病例详细介绍了病理和影像学表现,因为孤立性肝淋巴管瘤是一种极其罕见的肿瘤,以前的报告均未提供免疫组化特征的详细信息。