Huang Lu, Lu Lijian
Department of Infectious Diseases, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Department of Radiology, The Wuming Affiliated Hospital of Guangxi Medical University, Nanning, China.
Front Genet. 2021 Jun 17;12:638636. doi: 10.3389/fgene.2021.638636. eCollection 2021.
The aim of the present study was to describe the computed tomography (CT) characteristics of primary liver carcinosarcoma (PLCS) and to explore the pathological basis for the diagnosis of primary hepatocellular carcinoma sarcoma. Three male patients with PLCS were included in the present retrospective research, and the age was ranged from 52 to 63 years. The plain CT scan and third-stage enhancement scan were performed on patients. The pathological characteristics were analyzed. Stomachache was the main clinical symptoms of the three patients. Cirrhosis background was confirmed in one patients, and chronic Hepatitis B background was confirmed in other two patients. According to the results of CT, the inner diameter of the tumors ranged from 8.6 to 27.0 cm. The fibrous pseudocapsule around the tumor tissues was observed in two patients. Tumor tissues from all three patients were composed of sarcomatous and carcinomatous components. For carcinomatous components, hepatocellular carcinoma was observed in one patient and cholangiocarcinoma was observed in the other two patients. For sarcomatous components, angiosarcoma was observed in two patients and malignant fibrous histiocytoma was observed in another one patient. The tumor tissues were visualized as heterogeneous low density with large sheets of necrotic cystic lesions or thick-walled areas of multilocular cystic lesions using the plain CT scan. Edge-to-center filling and strengthening lesions, mild to moderate enhanced parenchyma at the arterial phase, and isodensity between the tumor parenchyma and the surrounding liver parenchyma at the portal vein phase or delayed phase were observed using the third-stage enhancement scan. CT characteristics observed in the present study were of great benefit for the diagnosis of PLCS.
本研究的目的是描述原发性肝脏癌肉瘤（PLCS）的计算机断层扫描（CT）特征，并探讨原发性肝细胞癌肉瘤诊断的病理基础。本项回顾性研究纳入了3例PLCS男性患者，年龄在52至63岁之间。对患者进行了CT平扫和三期增强扫描，并分析了病理特征。3例患者的主要临床症状均为腹痛。其中1例患者证实有肝硬化背景，另外2例患者证实有慢性乙型肝炎背景。根据CT结果，肿瘤内径为8.6至27.0 cm。2例患者观察到肿瘤组织周围有纤维假包膜。所有3例患者的肿瘤组织均由肉瘤成分和癌成分组成。对于癌成分，1例患者为肝细胞癌，另外2例患者为胆管癌。对于肉瘤成分，2例患者为血管肉瘤，另1例患者为恶性纤维组织细胞瘤。CT平扫显示肿瘤组织呈不均匀低密度，伴有大片坏死囊性病变或多房囊性病变的厚壁区域。三期增强扫描观察到病灶从边缘向中心填充强化，动脉期实质呈轻度至中度强化，门静脉期或延迟期肿瘤实质与周围肝实质密度相等。本研究中观察到的CT特征对PLCS的诊断有很大帮助。
