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肝脏炎性假瘤:一种酷似恶性肿瘤的罕见良性肿瘤。

Inflammatory pseudotumor of the liver: a rare benign tumor mimicking a malignancy.

作者信息

Lacaille F, Fournet J C, Sayegh N, Jaubert F, Revillon Y

机构信息

Department of Paediatrics, Necker-Enfants Malades Hospital, Paris, France.

出版信息

Liver Transpl Surg. 1999 Jan;5(1):83-5. doi: 10.1002/lt.500050101.

Abstract

We describe a 9-month-old boy in whom a hepatic tumor called angioma was diagnosed on ultrasonography, performed for abdominal pain. He was asymptomatic until 9 months later, when he presented with weight loss, jaundice, and a hard tumor in the left liver lobe. Radiological examination showed a calcified and heterogeneous tumor, amputation of the left portal vein, and dilatation of bile ducts, strongly suggesting malignancy. However, liver biopsy showed the typical findings of inflammatory pseudotumor, which are myofibroblastic cells and perivascular plasmocytes in a dense collagenous stroma. The tumor was surgically removed without local recurrence with a 2-year follow-up. Inflammatory pseudotumor in childhood is more common in the lung and elsewhere is often mistaken for a slowly growing cancer. This case points out the difficulties in the radiological evaluation of liver tumors in childhood and the importance of the histological differentiation of this lesion from malignancy before laparotomy for adequate indication of the treatment, which includes no medical treatment and surgery as conservative as possible.

摘要

我们描述了一名9个月大的男孩,因腹痛进行超声检查时被诊断出患有肝血管瘤。在9个月前他一直无症状,之后出现体重减轻、黄疸以及左肝叶的硬肿块。放射学检查显示为钙化且不均质的肿瘤、左门静脉截断以及胆管扩张,强烈提示为恶性肿瘤。然而,肝脏活检显示为炎性假瘤的典型表现,即在致密胶原基质中有肌成纤维细胞和血管周围浆细胞。肿瘤通过手术切除,2年随访无局部复发。儿童炎性假瘤在肺部更常见,在其他部位常被误诊为生长缓慢的癌症。该病例指出了儿童肝脏肿瘤放射学评估的困难,以及在剖腹手术前将此病变与恶性肿瘤进行组织学鉴别对于适当治疗指征的重要性,其中包括不进行药物治疗以及尽可能采取保守手术。

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