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原发性肝血管肉瘤的补充评论:一例报告

A complementary comment on primary hepatic angiosarcoma: A case report.

作者信息

Gulmez Ali Osman, Aydin Sonay, Kantarci Mecit

机构信息

Department of Radiology, Erzincan University, Erzincan 24100, Turkey.

出版信息

World J Clin Cases. 2023 Mar 16;11(8):1814-1822. doi: 10.12998/wjcc.v11.i8.1814.

Abstract

BACKGROUND

This article examines primary hepatic angiosarcoma (PHA) and fat-poor angiomyolipoma (AML), two uncommon vascular cancers. Clinical decisions in these situations are frequently aided by pathology reports and imaging techniques. Uncommon malignant tumors of the vascular endothelium include PHA. Another diagnosis that should not be overlooked when employing contrast-enhanced MR and contrast-enhanced computed tomography (CT) imaging techniques is fat-poor AML, one of the uncommon vascular tumors of the liver. In both conditions, biopsy is the primary means of diagnosis.

CASE SUMMARY

In our article, besides the diagnosis of PHA, fat-poor AML, one of the other rare vascular tumors of the liver, is mentioned. In the case, a 50-year-old female patient with VHL Syndrome was admitted to our hospital with nonspecific lesions such as right upper quadrant pain, weight loss, and nausea. Abdominal ultrasonography (US) revealed a hypoechoic heterogeneous lesion with occasional faint contours. In computed tomography, it was observed as a hyperdense nodular lesion in segment 4. Magnetic resonance imaging (MRI) revealed that the lesion did not contain fat. In connection with the known history of VHL Syndrome, we first evaluated the possibility of AML. Thereupon, a histopathological sample was taken and the diagnosis was made as fat-poor AML with 5% fat content.

CONCLUSION

In conclusion, PHA in our case report and fat-poor AML in our clinic are two uncommon liver vascular malignancies with comparable incidences. Important imaging techniques like contrast-enhanced US (CEUS), CECT, and CEMRI give us substantial advantages in both cases. However, a biopsy is used to provide the final diagnosis.

摘要

背景

本文探讨原发性肝血管肉瘤(PHA)和乏脂性血管平滑肌脂肪瘤(AML)这两种罕见的血管性癌症。在这些情况下,临床决策常常借助病理报告和成像技术。血管内皮的罕见恶性肿瘤包括PHA。在使用对比增强磁共振成像(MR)和对比增强计算机断层扫描(CT)成像技术时,另一个不应被忽视的诊断是乏脂性AML,它是肝脏罕见的血管性肿瘤之一。在这两种情况下,活检都是主要的诊断手段。

病例摘要

在我们的文章中,除了PHA的诊断外,还提到了肝脏的另一种罕见血管性肿瘤——乏脂性AML。在该病例中,一名患有VHL综合征的50岁女性患者因右上腹疼痛、体重减轻和恶心等非特异性病变入院。腹部超声(US)显示一个低回声不均匀病变,边界偶尔模糊。在计算机断层扫描中,该病变在第4段表现为高密度结节性病变。磁共振成像(MRI)显示该病变不含脂肪。结合已知的VHL综合征病史,我们首先评估了AML的可能性。随后,采集了组织病理学样本,诊断为脂肪含量为5%的乏脂性AML。

结论

总之,我们病例报告中的PHA和我们诊所中的乏脂性AML是两种发病率相当的罕见肝脏血管恶性肿瘤。重要的成像技术,如对比增强超声(CEUS)、CT增强扫描(CECT)和磁共振增强成像(CEMRI),在这两种情况下都给我们带来了很大优势。然而,最终诊断仍需依靠活检。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f780/10037275/82f15c0d55bb/WJCC-11-1814-g001.jpg

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