Bălăceanu Lavinia Alice, Diaconu Camelia Cristina, Aron Gheorghiţa
Internal Medicine Department, "Sf. Ioan" Clinical Emergency Hospital,Bucharest, Romania.
Internal Medicine Department, Clinical Emergency Hospital Bucharest, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Med Ultrason. 2014 Jun;16(2):172-4. doi: 10.11152/mu.201.3.2066.162.lab1.
We report the case of a 84-year-old admitted with symptoms of congestive heart failure. Ultrasonography revealed a hyperechoic nodule in the left lobe of the liver, with a peripheral hypoechoic rim, multiple irregular hypoechoic nodules in both hepatic lobes, portal vein, inferior vena cava, and right atrium thrombosis. On ultrasonographic and alpha-fetoprotein criteria the case was interpreted as hepatocellular carcinoma with Budd-Chiari syndrome. The particularity of the case is the initial presentation of the hepatocellular carcinoma as Budd-Chiari syndrome. The inferior vena cava and right atrium thrombosis, as a cause of secondary Budd-Chiari syndrome in a patient with hepatocellular carcinoma, has been rarely reported.
我们报告一例84岁因充血性心力衰竭症状入院的病例。超声检查显示肝脏左叶有一个高回声结节，周边有低回声边缘，两肝叶有多个不规则低回声结节，门静脉、下腔静脉及右心房血栓形成。根据超声检查和甲胎蛋白标准，该病例被诊断为伴有布加综合征的肝细胞癌。该病例的特殊性在于肝细胞癌最初表现为布加综合征。肝细胞癌患者中，下腔静脉和右心房血栓形成作为继发性布加综合征的病因，鲜有报道。
