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肝硬化患者肝脏实性肿块的处理方法

Approach to Solid Liver Masses in the Cirrhotic Patient.

作者信息

Assy Nimer, Assy Najib, Samuel Nir, Lerman Aracdi, Nseir William

机构信息

Liver Unit, Ziv Medical Center, Safed, Israel; Technion Institute, Haifa, Israel.

Liver Unit, Ziv Medical Center, Safed, Israel.

出版信息

Gastroenterology Res. 2009 Oct;2(5):259-267. doi: 10.4021/gr2009.10.1314. Epub 2009 Sep 20.

Abstract

Liver masses in cirrhosis are increasingly being recognized with the use of new imaging modalities. The majority of these lesions are detected by ultrasound, enhanced CT and MRI. The most likely diagnosis of a solid liver lesion in a cirrhotic liver is hepatocellular carcinoma, followed by high grade or low grade dysplastic nodule, and cholangiocarcinoma. Lymphoma and liver metastasis are extremely rare. Diagnosis is made by contrast enhanced ultrasound, multi detector (MDCT) and MRI. Fine needle core biopsy (FNCB) or aspiration (FNAB) or both may be required in doubtful cases. If uncertainty persists on the nature of the lesion, surgical liver resection is recommended. This review discusses the main characteristics of the most common solid liver masses in cirrhotic patient.

摘要

随着新型成像技术的应用,肝硬化患者肝脏肿块越来越多地被发现。这些病变大多通过超声、增强CT和MRI检测出来。肝硬化肝脏中实性肝病变最可能的诊断是肝细胞癌,其次是高级别或低级别发育异常结节以及胆管癌。淋巴瘤和肝转移极为罕见。通过超声造影、多排探测器(MDCT)和MRI进行诊断。在疑难病例中可能需要细针穿刺活检(FNCB)或抽吸活检(FNAB),或两者都做。如果病变性质仍不确定,建议进行肝切除术。本综述讨论了肝硬化患者中最常见的实性肝肿块的主要特征。

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本文引用的文献

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Cholangiocarcinoma: a compact review of the literature.胆管癌:文献综述
World J Gastroenterol. 2008 Nov 14;14(42):6458-66. doi: 10.3748/wjg.14.6458.
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Malignant transformation of hepatic adenomas.肝腺瘤的恶性转化
Mod Pathol. 2008 Apr;21(4):491-7. doi: 10.1038/modpathol.2008.8. Epub 2008 Feb 1.
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Screening for hepatocellular carcinoma.筛查肝细胞癌。
Hepatol Res. 2007 Sep;37 Suppl 2:S152-65. doi: 10.1111/j.1872-034X.2007.00180.x.

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