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肝紫癜病:罕见肝脏疾病的2例报告及其鉴别诊断

Peliosis hepatis: 2 case reports of a rare liver disorder and its differential diagnosis.

作者信息

Dai Yi-Ning, Ren Ze-Ze, Song Wen-Yuan, Huang Hai-Jun, Yang Dan-Hong, Wang Ming-Shan, Huang Yi-Cheng, Chen Mei-Juan, Zhang Jia-Jie, Tong Yong-Xi, Pan Hong-Ying

机构信息

Department of Infectious Diseases, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College Department of Infectious Diseases, the Second Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang, China.

出版信息

Medicine (Baltimore). 2017 Mar;96(13):e6471. doi: 10.1097/MD.0000000000006471.

Abstract

RATIONALE

Peliosis hepatis (PH) is a rare tumor-like liver lesion composed of multiple blood-filled cavities within the liver parenchyma. It is hard to differentiate PH from other liver lesions by imaging, such as carcinoma, metastases, or abscess.

PATIENT CONCERNS

Here, we reported 2 cases that presented with liver lesions under ultrasound and computed tomography (CT) scanning, without any history of liver diseases or drug usage traced back.

DIAGNOSES

Liver biopsy and laparoscopy were processed, and the lesions were eventually diagnosed as PH by histopathology, which microscopically presented with multiple sinusoidal dilatations with blood-filled cystic spaces.

INTERVENTIONS

After the liver biopsy or laparoscopy, the patients were discharged and followed up in the clinic.

OUTCOMES

Both patients were followed up for at least 1 year with good recovery.

LESSONS

PH should always be recognized in the differentiation of liver lesions, particularly indistinctive lesion(s) without any history of liver-related diseases.

摘要

理论依据

肝紫癜病(PH)是一种罕见的肿瘤样肝脏病变,由肝实质内多个充满血液的腔隙组成。通过影像学检查很难将PH与其他肝脏病变区分开来,如癌、转移瘤或脓肿。

患者情况

在此,我们报告2例患者,他们在超声和计算机断层扫描(CT)检查时发现肝脏有病变,追溯既往无任何肝脏疾病或用药史。

诊断

进行了肝脏活检和腹腔镜检查,最终通过组织病理学诊断病变为PH,显微镜下表现为多个充满血液的囊性间隙的窦性扩张。

干预措施

肝脏活检或腹腔镜检查后,患者出院并在门诊随访。

结果

两名患者均随访至少1年,恢复良好。

经验教训

在鉴别肝脏病变时,尤其是对于无任何肝脏相关疾病史的不典型病变,应始终考虑到PH。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65c3/5380268/b45744c684e7/medi-96-e6471-g001.jpg

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