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结直肠癌患者肝局灶性血管扩张症酷似转移性肝肿瘤。

Focal peliosis hepatis in a colon cancer patient resembling metastatic liver tumor.

机构信息

Department of Gastroenterology, Shanghai East Hospital Affiliated to Tongji University, Shanghai 200120, China.

出版信息

World J Gastroenterol. 2012 Nov 7;18(41):5999-6002. doi: 10.3748/wjg.v18.i41.5999.

Abstract

Peliosis hepatis (PH) is a rare benign condition characterized by the presence of multiple, randomly distributed, blood filled cystic areas of variable size within the liver parenchyma. PH is difficult to recognize and may be mistaken for neoplasm, metastases or multiple abscesses. A 75-year-old female with a previous history of colon cancer was admitted when a liver mass in the right liver lobe was found 11 mo after surgery during the follow-up period. Computed tomography and magnetic resonance imaging scan of the abdomen were performed. The initial possible diagnosis was metastatic hepatocellular carcinoma. The patient underwent excision of the hepatic segment where the nodule was located. The pathological diagnosis of the surgical specimen was PH. PH should be considered in the differential diagnosis of new liver lesions in patients whose clinical settings do not clearly favor metastasization. Clinicians and radiologists must recognize these lesions to minimize the probability of misdiagnosis and inappropriate treatment.

摘要

肝血窦扩张症(PH)是一种罕见的良性病变,其特征是肝脏实质内存在多个大小不一、随机分布、充满血液的囊性区域。PH 很难识别,可能被误诊为肿瘤、转移灶或多发性脓肿。一名 75 岁女性,既往有结肠癌病史,在随访期间于术后 11 个月发现右肝叶有肝肿块而入院。行腹部计算机断层扫描和磁共振成像检查。最初的可能诊断为转移性肝细胞癌。患者接受了位于结节所在肝段的切除术。手术标本的病理诊断为 PH。对于临床情况不明显倾向于转移的患者,在鉴别新的肝脏病变时应考虑 PH。临床医生和放射科医生必须认识到这些病变,以最大限度地降低误诊和不适当治疗的概率。

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