Department of Surgery, Mito Saiseikai General Hospital, 3-3-10 Futabadai, Mito, Ibaraki, 311-4198, Japan.
Surg Today. 2011 Sep;41(9):1270-4. doi: 10.1007/s00595-010-4465-z. Epub 2011 Aug 26.
We report a case of pelioid-type well-differentiated hepatocellular carcinoma (HCC) in a 54-year-old woman with a history of taking oral contraceptives. She was not infected with hepatitis viruses and her liver function test results were normal. Contrast-enhanced computed tomography showed an irregular-shaped and remarkably enhanced tumor with central necrosis. The tumor was vaguely nodular without capsules, and consisted of multiple pelioid cysts and sinusoidal dilatations with transitional forms between them. The pelioid cysts were directly surrounded by neoplastic cells with fatty degeneration. Since pelioid-type HCC has similar radiological and pathological features to peliosis hepatis, it is difficult to differentiate them based on drug history and imaging studies. The detection of stromal invasion into the portal area is necessary to distinguish well-differentiated HCC from benign hepatic tumors.
我们报告了一例 54 岁女性服用口服避孕药后发生的肝胞腺癌(HCC)。该患者未感染肝炎病毒,肝功能检查结果正常。增强 CT 显示肿瘤呈不规则形状,显著增强,中央有坏死。肿瘤呈模糊结节状,无包膜,由多个肝胞性囊肿和窦状扩张组成,其间有过渡形式。肝胞性囊肿直接被脂肪变性的肿瘤细胞包围。由于肝胞型 HCC 的影像学和病理学特征与肝血窦扩张相似,因此根据药物史和影像学研究很难对其进行区分。检测间质侵犯门脉区对于将分化良好的 HCC 与良性肝肿瘤区分开来是必要的。