Samad Muhammad Adeel, Ali Annis, Shih-Della Penna Diane C, Tiedebohl Scott
WellSpan York Hospital, Department of Surgery, York, PA, USA.
J Surg Case Rep. 2021 Sep 14;2021(9):rjab387. doi: 10.1093/jscr/rjab387. eCollection 2021 Sep.
Nontraumatic liver herniation through diaphragm is a rare condition. We present a case of a 54-year-old female presenting with nontraumatic liver herniation mimicking a right lower lobe mass. Patient was noted to have growth of two right lower lobe lung nodules from 1.5 cm × 2.8 cm and 0.9 cm × 1.3 in August 2009 to 2.8 cm × 4.1 cm and 1.1 cm × 1.4 cm in March 2019 on computerized tomography (CT) scan. PET scan as well as the growth pattern was consistent with low-grade malignancy likely carcinoid tumor. CT-guided biopsy was not feasible because of location of the mass. We performed robotic thoracoscopy with plan for wedge resection, however gross inspection of the thoracic cavity revealed two masses on the dome of the diaphragm with appearance like liver and correlating with nodules seen on CT scan. A core needle biopsy showed that it was benign liver tissue.
非创伤性肝经膈肌疝是一种罕见的病症。我们报告一例54岁女性，表现为非创伤性肝疝，酷似右下叶肿块。2009年8月计算机断层扫描（CT）显示患者右下叶有两个肺结节，大小分别为1.5厘米×2.8厘米和0.9厘米×1.3厘米，到2019年3月增大至2.8厘米×4.1厘米和1.1厘米×1.4厘米。正电子发射断层显像（PET）扫描以及生长模式符合低度恶性，可能为类癌肿瘤。由于肿块位置原因，CT引导下活检不可行。我们进行了机器人辅助胸腔镜检查并计划楔形切除术，然而胸腔的大体检查发现膈肌顶部有两个肿块，外观类似肝脏，与CT扫描上所见结节相关。芯针活检显示为良性肝组织。
