摘要
目的:总结肉瘤样肝细胞癌的临床与CT影像学特征,以提高对该类肝脏肿瘤的诊断水平.方法:回顾性分析8例肉瘤样肝细胞癌的临床表现、病理特点和CT特征性表现.结果:8例患者均为男性,平均年龄40岁,均出现上腹部胀痛,其中6例(6/8)出现发热,但血常规提示WBC计数正常,HBsAg均为阳性,血清甲胎球蛋白2例正常,余6例平均约123 g/L,肝功能均为Child-Pugh A级,7例无肝硬化基础.8例肉瘤样肝细胞癌均为巨块型,直径约5-10 cm,以单发、团块状、囊实性病变为主,多无肝硬化背景(7/8例).6例CT平扫表现为囊实性低密度影,其内见条状分隔影(2例)及散在分布的条状、结节状软组织密度影(4例),增强扫描呈不均匀强化,余2例CT平扫表现为不规则低密度影,增强扫描未见明显强化.3例可见门静脉癌栓.结论:肉瘤样肝细胞癌的临床与CT特征具有肝细胞癌及肉瘤的双重特征.
AIM： To summarize the clinical and spiral CT characteristics of primary sarcomatoid hepatic carcinoma in order to improve its diagnosis.
METHODS： CT findings of 8 patients with primary sarcomatoid hepatic carcinoma were analyzed retrospectively. Plain and enhanced spiral CT scan was performed for all patients.
RESULTS： All the 8 patients were males with a mean age of 43 years. Of them, 6 had fever. Laboratory test showed a normal count of WBC and positive HBsAg. AFP was normal in 2 patients and 123 g/L in 6 patients. All the patients had a Child-Pugh A of liver function, 7 had no liver cirrhosis. The diameter of primary sarcomatoid hepatic carcinoma ranged 5 -10 cm. Huge cystic-solid lesions with irregular septa were found in 2 patients, multiple nodulated soft tissue shadows in 4 patients, and inhomogeneous low-density lesion with unconspicuous enhancement in the other 2 patients. Can-cer embolus in the portal vein was displayed in 3 out of the 8 patients.
CONCLUSION： Primary sarcomatoid hepatic carcinoma is characterized by hepatic sarcoma and carcinoma. Its diagnosis depends largely on pathology and immunohistochemistry.
出处
《世界华人消化杂志》
CAS
北大核心
2008年第8期904-907,共4页
World Chinese Journal of Digestology
基金
教育部新世纪优秀人才资助项目~~
关键词
肝肿瘤
肉瘤样癌
体层摄影术
X线计算机
临床特征
Hepatic neoplasm
Sarcomatoid hepatocellular carcinoma
Tomogramphy
X-ray
Clinical characteristics
