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肝脏巨大海绵状血管瘤伴卫星结节:肿瘤/组织界面相关情况:一例报告

Giant cavernous hemangioma of the liver with satellite nodules: Aspects on tumour/tissue interface: A case report.

作者信息

Fischer Anne Kristin, Beckurts Karl Tobias Erich, Büttner Reinhard, Drebber Uta

机构信息

Institute of Pathology, University of Cologne, Köln 50937, North Rhine Westphalia, Germany.

Visceral Surgery, Severinsklösterchen Hospital Cologne, Cologne 50678, North Rhine Westphalia, Germany.

出版信息

World J Hepatol. 2023 May 27;15(5):707-714. doi: 10.4254/wjh.v15.i5.707.

Abstract

BACKGROUND

Giant hepatic cavernous hemangioma with multiple satellite nodules is a rare subtype of hepatic cavernous hemangioma, the most common vascular liver tumor. We report on a tumor with unusual histologic features: (1) Finger-like infiltration pattern; (2) lack of encapsulation; (3) blurred tumor/liver interface; and (4) massive satellitosis-referring to the article "Hepatic cavernous hemangioma: underrecognized associated histologic features".

CASE SUMMARY

A 60-year-old man presented with increasing uncharacteristic abdominal discomfort and mildly elevated blood parameters of acute inflammation. Imaging revealed an unclear, giant liver tumor of the left liver lobe. A massive vascular tumor with extensive satellitosis broadly infiltrating the adjacent liver parenchyma was resected hemihepatectomy of segments II/III. Histopathological diagnosis was giant hepatic cavernous hemangioma with multiple satellite nodules, featuring unusual characteristics hardly portrayed in the literature. Retrospectively, this particular morphology can explain the difficult pre- and perioperative diagnosis of a vascular liver tumor that is usually readily identifiable by modern imaging methods.

CONCLUSION

This case emphasizes the exact histological workup of tumor and tumor-induced parenchyma changes in radiologically unclassifiable liver tumors.

摘要

背景

巨大肝海绵状血管瘤伴多发卫星结节是肝海绵状血管瘤(最常见的肝脏血管肿瘤)的一种罕见亚型。我们报告一例具有不寻常组织学特征的肿瘤:(1)指状浸润模式;(2)无包膜;(3)肿瘤/肝脏界面模糊;(4)大量卫星灶形成——参考文章《肝海绵状血管瘤:未被充分认识的相关组织学特征》。

病例摘要

一名60岁男性因非特异性腹部不适加重及急性炎症相关血液指标轻度升高就诊。影像学检查发现左肝叶有一个边界不清的巨大肝脏肿瘤。切除了一个广泛存在卫星灶、广泛浸润相邻肝实质的巨大血管性肿瘤(Ⅱ/Ⅲ段半肝切除术)。组织病理学诊断为巨大肝海绵状血管瘤伴多发卫星结节,具有文献中鲜有描述的不寻常特征。回顾来看,这种特殊形态可以解释这个通常可通过现代影像学方法轻易识别的肝脏血管肿瘤术前和围手术期诊断困难的原因。

结论

本病例强调了对放射学上无法分类的肝脏肿瘤进行精确的肿瘤组织学检查以及肿瘤诱导的实质改变检查的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbfe/10251275/fafb04dfc4cd/WJH-15-707-g001.jpg

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