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肝脏孤立性坏死结节伴“环状”钙化:病例报告

Solitary necrotic nodules of the liver with "ring"-like calcification: A case report.

作者信息

Bao Jin-Peng, Tian Hu, Wang Hao-Chen, Wang Cong-Cong, Li Bo

机构信息

Department of General Surgery, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan 250014, Shandong Province, China.

Department of Gastroenterology, Shandong First Medical University, Jinan 250024, Shandong Province, China.

出版信息

World J Clin Cases. 2022 Jul 26;10(21):7409-7414. doi: 10.12998/wjcc.v10.i21.7409.

DOI:10.12998/wjcc.v10.i21.7409
PMID:36158018
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9353921/
Abstract

BACKGROUND

Solitary necrotic nodule of the liver (SNNL) is a rare benign lesion with a complete necrotic core and a clear fibrous capsule containing elastic fibers. We present the case of a patient with a radiographic computed tomography (CT) finding of "ring"-like annular calcification within the lesion and postoperative pathologic diagnosis of necrotic nodules wrapped by dense fibers in liver tissue, as well as the patient's subsequent management and outcome.

CASE SUMMARY

A 38-year-old Chinese woman with a history of systemic lupus erythematosus treated with prednisone and hydroxychloroquine, without any symptoms, was found to have hepatic space-occupying lesions by imaging examination at a health examination. A subsequent CT scan suggested a space-occupying lesion of the liver with annular calcification, which was not defined to be benign or malignant. After that, a laparoscopic hepatic space-occupying resection was performed. The postoperative pathological diagnosis was necrotic nodules wrapped by dense fibers in the liver tissue, and the final diagnosis was SNNL. The patient had an uneventful postoperative recovery.

CONCLUSION

There is a "ring"-like calcification in SNNL. This patient had a history of systemic lupus erythematosus, without a history of parasite infection, trauma, or tumor. Therefore, whether the etiology and pathological changes of SNNL are related to rheumatic immune diseases remains to be investigated.

摘要

背景

肝脏孤立性坏死结节(SNNL)是一种罕见的良性病变,具有完整的坏死核心和含有弹性纤维的清晰纤维包膜。我们报告一例患者,其影像学计算机断层扫描(CT)显示病变内有“环状”环形钙化,术后病理诊断为肝组织中被致密纤维包裹的坏死结节,以及该患者随后的治疗和结局。

病例摘要

一名38岁有系统性红斑狼疮病史且接受泼尼松和羟氯喹治疗的中国女性,无症状,在健康体检时经影像学检查发现肝脏有占位性病变。随后的CT扫描提示肝脏占位性病变伴有环状钙化,未明确其良恶性。此后,进行了腹腔镜肝脏占位性切除术。术后病理诊断为肝组织中被致密纤维包裹的坏死结节,最终诊断为SNNL。患者术后恢复顺利。

结论

SNNL中有“环状”钙化。该患者有系统性红斑狼疮病史,无寄生虫感染、外伤或肿瘤病史。因此,SNNL的病因及病理改变是否与风湿免疫性疾病有关仍有待研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c432/9353921/674f14ad9411/WJCC-10-7409-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c432/9353921/1604c6f594f3/WJCC-10-7409-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c432/9353921/e0b104d4c074/WJCC-10-7409-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c432/9353921/674f14ad9411/WJCC-10-7409-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c432/9353921/1604c6f594f3/WJCC-10-7409-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c432/9353921/e0b104d4c074/WJCC-10-7409-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c432/9353921/674f14ad9411/WJCC-10-7409-g003.jpg

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本文引用的文献

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Contrast-Enhanced Ultrasound Findings in Patients with Rare Solitary Necrotic Nodule of the Liver - a Multicenter Report.肝脏罕见孤立性坏死结节患者的超声造影表现——一项多中心报告
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A Challenging Case of Solitary Necrotic Nodules of the Liver Mimicking Hepatic Metastases: CT, MRI, and PET-CT Findings.一例酷似肝转移瘤的肝脏孤立性坏死结节的疑难病例:CT、MRI及PET-CT表现
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Imaging appearances of hepatic tuberculosis: experience with 12 patients.
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Solitary Necrotic Nodule of Liver (SNNL): A Report of Two Cases.肝脏孤立性坏死结节(SNNL):两例报告
J Clin Diagn Res. 2014 Mar;8(3):115-6. doi: 10.7860/JCDR/2014/5603.4127. Epub 2014 Mar 15.
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Solitary Necrotic Nodules of the Liver: Histology and Diagnosis With CT and MRI.肝脏孤立性坏死结节:组织学及CT与MRI诊断
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