Xin Huizhen, Li Haijun, Yu Honghui, Zhang Juan, Peng Weizhi, Peng Dechang
Department of Radiology, The First Affiliated Hospital, Nanchang University, Jiangxi Province, The People's Republic of China.
Medicine (Baltimore). 2019 Jul;98(29):e16497. doi: 10.1097/MD.0000000000016497.
Primary hepatic myelolipoma is a rare benign neoplasm comprising mature adipose tissue and marrow components in various proportions. Chemical shift imaging (CSI) can distinguish the lipid within the tumor clearly; however, there have been no reports on the CSI of hepatic myelolipoma.
A 20-year-old woman visited our hospital after discovering a space-occupying lesion in the liver with a history of more than 1 year. She felt distension pain and discomfort under the xiphoid process, accompanied by nausea, vomiting, and occasional chest oppression.
The tumor showed a well-defined mass with a pseudocapsule and a heterogeneous appearance on both T1- and T2-weighted magnetic resonance (MR) images. CSI analysis showed a signal decline within the tumor. Based on the histopathology, the tumor was diagnosed as hepatic myelolipoma.
The patient underwent a right hepatectomy, and the postoperative vital signs were stable. Two weeks later, the patient was discharged safely.
Although hepatic myelolipoma is extremely rare, this condition should be considered in differential diagnosis when CSI shows that hepatic lesions contain fatty.
原发性肝髓脂肪瘤是一种罕见的良性肿瘤，由不同比例的成熟脂肪组织和骨髓成分组成。化学位移成像（CSI）能够清晰地分辨肿瘤内的脂质；然而，目前尚无关于肝髓脂肪瘤化学位移成像的报道。
一名20岁女性在发现肝脏占位性病变1年多后前来我院就诊。她感到剑突下胀痛不适，伴有恶心、呕吐，偶尔还有胸闷。
肿瘤在T1加权和T2加权磁共振（MR）图像上显示为边界清晰、有假包膜且外观不均匀的肿块。化学位移成像分析显示肿瘤内信号下降。根据组织病理学检查，该肿瘤被诊断为肝髓脂肪瘤。
患者接受了右肝切除术，术后生命体征平稳。两周后，患者安全出院。
尽管肝髓脂肪瘤极为罕见，但当化学位移成像显示肝脏病变含有脂肪时，在鉴别诊断中应考虑到这种情况。
