Franceschini Tania, Malvi Deborah, Maroni Lorenzo, Ravaioli Matteo, Cescon Matteo, D'Errico Antonia, Vasuri Francesco
Pathology Unit, S.Orsola-Malpighi University Hospital, Bologna, Italy.
General and Transplant Surgery Unit, S.Orsola-Malpighi University Hospital, Bologna, Italy.
Ther Adv Gastrointest Endosc. 2019 May 6;12:2631774519844947. doi: 10.1177/2631774519844947. eCollection 2019 Jan-Dec.
We describe three cases of liver lesions, characterized by a discrepancy between presurgical imaging and histological features, in which the final histological diagnosis was quite different from what the surgeons expected. We present (1) a case of primary liver angiomyolipoma associated with focal nodular hyperplasia, (2) a case of perivascular epithelioid cell tumor, and (3) a case of liver splenosis associated with focal nodular hyperplasia. In all cases, a presurgical diagnosis of hepatocellular adenoma was made. Due to nonspecific clinical and radiological features, these rare liver lesions are often presurgically misdiagnosed, especially in young noncirrhotic patients. The association among different lesions represents one additional diagnostic challenge.
我们描述了三例肝脏病变病例,其特征为术前影像学检查与组织学特征存在差异,最终组织学诊断与外科医生的预期大不相同。我们呈现:(1)一例与局灶性结节性增生相关的原发性肝脏血管平滑肌脂肪瘤,(2)一例血管周上皮样细胞瘤,以及(3)一例与局灶性结节性增生相关的肝内脾组织植入。所有病例术前均诊断为肝细胞腺瘤。由于临床和放射学特征不具特异性,这些罕见的肝脏病变在术前常被误诊,尤其是在年轻的非肝硬化患者中。不同病变之间的关联更是增加了诊断难度。