Lee P Y, Wu C C, Wen M C, Chou G, Ho Y J, Liu T J
Division of General Surgery, Department of Surgery, Taichung Veterans General Hospital, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1996 Jan;57(1):74-8.
Two cases of rare hepatic angiomyolipoma are reported. Both represented with slight abdominal discomfort. The first patient complained of abdominal fullness, and had a normal physical examination and laboratory data. The second came with epigastralgia. Tenderness over right upper quadrant was noted and positive hepatitis B antigen was found. Ultrasound demonstrated hyperechoic hepatic lesion in both. Although diagnosis of hepatic angiomyolipoma was suspected by the radiological findings of ultrasound, CT, MRI, and angiography, it was confirmed by the histological presence of three mesenchymal components: abundant vessels, mature fat cells and smooth muscle cells. For fear of the coexistence of hepatocellular carcinoma, especially given the high prevalence area of Taiwan, surgical intervention was recommended if liver function permitted. Successful treatment was achieved by hepatic resection in both cases.
报告了两例罕见的肝脏血管平滑肌脂肪瘤。两例均表现为轻微腹部不适。首例患者主诉腹部胀满,体格检查及实验室检查数据均正常。第二例患者以上腹部疼痛就诊。右上腹有压痛,乙肝抗原阳性。超声检查显示两例肝脏均有高回声病变。尽管根据超声、CT、MRI及血管造影的影像学表现怀疑为肝脏血管平滑肌脂肪瘤,但通过组织学检查发现存在三种间叶成分:丰富的血管、成熟的脂肪细胞和平滑肌细胞得以确诊。由于担心合并肝细胞癌,尤其是考虑到台湾地区的高发病率,若肝功能允许,建议手术干预。两例均通过肝切除术获得成功治疗。