Long Xin, Zhang Lei, Cheng Qi, Chen Qian, Chen Xiao-Ping
Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China.
Endoscopic Unit, Department of Gastroenterology and Hepatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China.
World J Clin Cases. 2020 Oct 6;8(19):4633-4643. doi: 10.12998/wjcc.v8.i19.4633.
Hepatic lymphangioma, a malformation of the liver lymphatic system, is a rare benign neoplasm and usually coexists with other visceral lymphangiomas. Solitary hepatic lymphangioma is much more rarely seen and could cause a clinical misinterpretation as malignancy.
A 50-year-old woman with a liver mass of approximately 3.5 cm was initially diagnosed with hepatocellular carcinoma given the risk factors for liver cancer that she presented with, including infection and jaundice, and also together with imaging results, which showed the mass enhanced quickly in the arterial phase and faded fast in the venous phase. The patient did not have the surgery first but received three rounds of transarterial chemoembolization because of her anxiety and fears for operation. Finally, the patient underwent laparoscopic liver segment 4b resection and cholecystectomy and was discharged from the hospital only 10 d after the operation. The pathological examination indicated the mass as hepatic lymphangioma. The patient has been followed up for 30 mo without recurrence. To raise the awareness of this misdiagnosed case and to better diagnose and treat this rare disease in future, we reviewed the published literature of solitary hepatic lymphangioma for its clinical symptoms, imaging presentation, operative techniques, histology features and prognosis.
Solitary hepatic lymphangioma mimicking malignancy makes diagnosis difficult. Complete surgical resection is the first choice to treat solitary hepatic lymphangioma.
肝淋巴管瘤是肝脏淋巴系统的一种畸形,是一种罕见的良性肿瘤,通常与其他内脏淋巴管瘤共存。孤立性肝淋巴管瘤更为罕见,可能导致临床误诊为恶性肿瘤。
一名50岁女性,肝脏有一约3.5 cm的肿块,因其存在包括感染和黄疸在内的肝癌危险因素,且影像学结果显示肿块在动脉期快速强化、静脉期快速消退,最初被诊断为肝细胞癌。由于患者对手术存在焦虑和恐惧,未首先进行手术,而是接受了三轮经动脉化疗栓塞术。最终,患者接受了腹腔镜下肝4b段切除术和胆囊切除术,术后仅10天就出院了。病理检查显示肿块为肝淋巴管瘤。患者已随访30个月,无复发。为提高对这一误诊病例的认识,并在未来更好地诊断和治疗这种罕见疾病,我们回顾了已发表的关于孤立性肝淋巴管瘤的临床症状、影像学表现、手术技术、组织学特征和预后的文献。
酷似恶性肿瘤的孤立性肝淋巴管瘤使诊断困难。完整的手术切除是治疗孤立性肝淋巴管瘤的首选方法。