Wang Cheng-En, Sun Cheng-Jian, Huang Shuai, Wang Yan-Hua, Xie Ling-Ling
Cheng-En Wang, Cheng-Jian Sun, Shuai Huang, Yan-Hua Wang, Ling-Ling Xie, Department of Interventional Radiology, Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China.
World J Gastroenterol. 2014 Nov 21;20(43):16377-80. doi: 10.3748/wjg.v20.i43.16377.
Calcification of the portal venous system is a rare entity that can be incidentally discovered during computed tomography (CT). We describe a case of extensive calcifications in the portal venous system in a middle-aged male patient with hepatocellular carcinoma (HCC). This patient presented with epigastric pain that had no obvious origin prior to admission. Laboratory examinations were positive for hepatitis B surface antigen and α-fetoprotein, and severe esophageal and gastric varices were detected during gastroscopy. Abdominal X-ray plain film showed well-defined linear and track-like calcification, with irregular margins directed along the course of the portal venous system. CT revealed extensive calcifications along the course of the portal, splenic, superior mesenteric and gastroesophageal veins. He underwent splenectomy 22 years ago due to splenomegaly and partial hepatectomy seven months before because of HCC of low-grade differentiation, confirmed by pathology. Finally, the patient was diagnosed with postoperative recurrent HCC and extensive portal venous system calcification after selective hepatic angiography under digital subtraction angiography.
门静脉系统钙化是一种罕见的情况，可在计算机断层扫描（CT）检查时偶然发现。我们报告一例中年男性肝细胞癌（HCC）患者出现广泛的门静脉系统钙化。该患者入院前表现为原因不明的上腹部疼痛。实验室检查乙肝表面抗原和甲胎蛋白呈阳性，胃镜检查发现严重的食管和胃静脉曲张。腹部X线平片显示清晰的线性和条索状钙化，边缘不规则，沿门静脉系统走行分布。CT显示门静脉、脾静脉、肠系膜上静脉和胃食管静脉走行区广泛钙化。患者22年前因脾肿大行脾切除术，7个月前因低分化HCC行部分肝切除术，术后病理确诊。最后，在数字减影血管造影下进行选择性肝血管造影后，该患者被诊断为术后复发性HCC并伴有广泛的门静脉系统钙化。
