Grønlykke Lars, Tarp Britta, Dutoit Stephen Hamilton, Wilkens Rune
Diagnostic Centre, Regionshospitalet Silkeborg, Silkeborg, Denmark.
BMJ Case Rep. 2013 Sep 26;2013:bcr2013200539. doi: 10.1136/bcr-2013-200539.
A 33-year-old woman was referred for an ultrasound of the abdomen because of biliary colic. The symptoms had started 2 months after giving birth to her first child. The ultrasound showed gallstones, but it also revealed multiple focal liver lesions that were initially thought to be malignant. The examination was supplemented with a CT scan, contrast-enhanced ultrasound (CEUS) and MRI. The lesions were suspected to be peliosis hepatis-a rare morphological entity characterised by multiple blood-filled cavities in the liver. Because of uncertainty as to the aetiology of the lesions demonstrated at CEUS and MRI, the diagnosis was definitively confirmed by large-size needle biopsies. Regular size biopsies were initially insufficient for diagnosis. The use of oral contraceptives for several years or the recent pregnancy may have been the cause of peliosis hepatis in this patient.
一名33岁女性因胆绞痛接受腹部超声检查。症状在她生下第一个孩子2个月后开始出现。超声显示有胆结石,但也发现了多个肝脏局灶性病变,最初认为是恶性的。检查还补充了CT扫描、对比增强超声(CEUS)和MRI。这些病变怀疑是肝紫癜——一种罕见的形态学实体,其特征是肝脏内有多个充满血液的腔隙。由于CEUS和MRI显示的病变病因不确定,通过大尺寸针吸活检最终确诊。常规尺寸活检最初不足以确诊。该患者使用口服避孕药数年或近期怀孕可能是肝紫癜的病因。