摘要
目的:探讨肉瘤样肝细胞癌(SHC)临床CT表现和病理特征,提高对此病的认识。方法:对经病理证实的6例SHC的CT和临床资料进行回顾性分析。结果:5例患者均有上腹部胀痛及发热,但血常规提示WBC计数正常,HBsAg均为阳性,血清AFP不高,无肝硬化基础。全部患者均表现为肝内直径3～11cm的囊实质性肿块,其中右肝4例,左肝1例,4例边缘清楚,2例边界不清。CT平扫见2例密度均匀,4例密度不均匀,内有液化坏死或纤维化及钙化;增强CT上1例呈均匀强化,4例呈不均匀轻至中度强化,1例不强化,>6cm的肿瘤呈肿瘤内条片状强化。2例可见门脉癌栓形成。结论:SHC因具有肝细胞癌及肉瘤的双重成分在临床病理与CT特征而具一定特征性,对本病定性诊断有价值。
Objective：To investigate the value of computed tomography （CT） in the diagnosis of sarcomatoid hepatocellular carcinoma （SHC） correlated with the pathological findings.Methods：Tile CT and clinical data of all 6 cases of pathologically proved SHC were reviewed retrospectively. Results：5 patients were males and 1 patient female, with a mean age of 43 years. They underwent upper abdomen pain and fever, Laboratory test showed a normal count of WBC and positive HBsAg. AFP was normal, 6 had no liver cirrhosis. All cases presented with a spheroid solid hepatic mass ranged from 3 to 11 cm in diameter （average 7 cm） .4 lesions in right lower lobe, 1 in left lobe. Among 6 cases： 4 cases had clear margin and 2 hadn＇t. Two massess were homogenous in density,and the other 4 were inhomogeneous in density with formation of central cavity or calcification. After intravenons contrast administration, one lesion showed homogeneous enhancement, and the other 4 lesions had inhomogencons enhancement. The lesions with diameter larger than 6 crn showed marginal or patch-like enhancement. Cancer embolus in the portal vein was displayed in 2 out of the 6 patients. Corlclusion：There are some relatively specific featuresof SHC on CT, which may be helpful for diagnosis.
出处
《医学影像学杂志》
2010年第1期63-66,共4页
Journal of Medical Imaging
关键词
肉瘤样肝细胞癌
体层摄影术
X线计算机
临床
病理学
Sarcomatoid hepatceellular carcinoma （SHC）
Tomography,X-ray computed
Clinical
Pathology
