Saeger W
Abteilung für Pathologie, Marienkrankenhaus, Hamburg.
Fortschr Med. 1990 Jun 10;108(17):329-33.
A group of 5 primary angiomas of the liver (4 angiosarcomas, 1 cavernous hemangioma) was studied. Classification, differential diagnosis and pathogenesis are discussed. Angiosarcomas may be caused by exposure to thorotrast (2 of our 4 tumors) or of polyvinylchloride. Highly cellular tumors with a herringbone-pattern must be differentiated from primarily extrahepatic fibrosarcomas or myosarcomas, and highly cellular solid or medullary tumors from metastasis from a carcinoma or lymphoma. Immunohistology--also in our tumors--permits the identification of angiomas by the demonstration of factor VIII and basement membrane protein, which are negative in other tumors. The binding of lectin Ulex europaeus can also be helpful. The common benign cavernous hemangioma is diagnosed very readily morphologically, but clinical and sonographic diagnosis can be difficult. Its biological significance is to be seen merely in possible rupture and hemorrhage.
对一组5例肝脏原发性血管瘤(4例血管肉瘤,1例海绵状血管瘤)进行了研究。讨论了其分类、鉴别诊断及发病机制。血管肉瘤可能由接触钍造影剂(我们的4例肿瘤中有2例)或聚氯乙烯引起。具有人字形结构的高细胞性肿瘤必须与原发性肝外纤维肉瘤或肌肉肉瘤相鉴别,高细胞性实性或髓样肿瘤必须与癌或淋巴瘤的转移瘤相鉴别。免疫组织化学——在我们的肿瘤中也是如此——通过显示因子VIII和基底膜蛋白来识别血管瘤,而这些在其他肿瘤中为阴性。荆豆凝集素的结合也可能有帮助。常见的良性海绵状血管瘤在形态学上很容易诊断,但临床和超声诊断可能困难。其生物学意义仅在于可能发生破裂和出血。