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肝脏血管平滑肌脂肪瘤的诊断和治疗
毛一雷,杜顺达,桑新亭,杨志英,卢欣,赵海涛,钟守先,黄洁夫
毛一雷、杜顺达、桑新亭、杨志英、卢欣、赵海涛、钟守先、黄洁夫,中国医学科学院 中国协和医科大学 北京协和医院肝脏外科,100730

摘要:目的 总结肝脏血管平滑肌脂肪瘤(HAML)的临床、影像学和病理学特点以及治疗方法。方法 回顾性分析2003年11月至2007年5月我科收治的6例HAML患者的临床资料。所有患者行B超、CT检查之后均行肝切除术,术后经病理及免疫组化明确诊断并随访至今。结果 6例患者中女5例,男1例,多无明显临床症状,且血清学检查正常。影像学显示肿瘤形态规则、边界清晰,增强后早期及延迟增强。术中发现肿瘤位于右肝3例、左肝3例,大小为4 cm×4 cm×3 cm~17 cm×10 cm×10 cm。病理结果提示病灶由不同比例的血管、平滑肌细胞及脂肪组成,免疫组化结果HMB-45(6/6)、SMA(6/6)表达阳性。所有病例手术切除后随访6~48个月,至今无复发。结论 HAML在肝脏占位中并不多见,肿瘤以良性为主,但存在恶性生物学行为可能。外科医师术前诊断时应有HAML的概念,一旦诊断宜尽早手术,术后密切随诊。

关键词:

肝肿瘤;血管肌脂瘤;诊断;肝切除术

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文献标引:毛一雷,杜顺达,桑新亭,杨志英,卢欣,赵海涛,钟守先,黄洁夫.肝脏血管平滑肌脂肪瘤的诊断和治疗.中华临床医师杂志(电子版),2008,2(2):142-147.  

参考文献

[1] Zhong DR, Ji XL. Hepatic angiomyolipoma-misdiagnosis as hepatocellular carcinoma:A report of 14 cases.World J Gastroenterol,2000,6(4):608-612.[PubMed]
[2] Mizuguchi T,Katsuramaki T,Nobuoka T,et al.Growth of hepatic angiomyolipoma indicating malignant potential.J Gastroenterol Hepatol,2004,19(11):1328-1330.[PubMed]
[3] Flemming P,Lehmann U,Becker T,et al.Common and epithelioid variants of hepatic angiomyolipoma exhibit clonal growth and share a distinctive immunophenotype.Hepatology,2000,32(2):213-217.[PubMed]
[4] Folpe AL,Goodman ZD,Ishak KG,et al.Clear cell myomelanocytic tumor of the falciform ligament/ligamentum teres:a novel member of the perivascular epithelioid clear cell family of tumors with a predilection for children and young adults.Am J Surg Pathol,2000,24(9):1239-1246.[PubMed]
[5] Makhlouf HR,Ishak KG,Shekar R,et al.Melanoma markers in angiomyolipoma of the liver and kidney:a comparative study.Arch Pathol Lab Med,2002,126(1):49-55.[PubMed]
[6] Yeh CN,Lee KF,Chen MF.Immunohistochemical study of hepatic angiomyolipoma.Hepatogastroenterology,2005,52(64):1151-1153.[PubMed]
[7] Tang LH,Hui P,Garcia-Tsao G,et al.Multiple angiomyolipomata of the liver:a case report.Mod Pathol,2002,15(2):167-171.[PubMed]
[8] Rimola J, Martín J, Puig J, et al. Hepatic angiomyolipoma:progressive changes in size and tumor composition.Abdom Imaging,2003,28(5):665-667.[PubMed]
[9] Basaran C, Karcaaltincaba M, Akata D, et al. Fat-containing lesions of the liver:cross-sectional imaging findings with emphasis on MRI.AJR Am J Roentgenol,2005,184(4):1103-1110.[PubMed]
[10] Dalle I,Sciot R,De Vos R,et al.Malignant angiomyolipoma of the liver:a hitherto unreported variant.Histopathology,2000,36(5):443-450.[PubMed]
[11] Yang CY, Ho MC, Jeng YM, et al. Management of hepatic angiomyolipoma.J Gastrointest Surg,2007,11(4):452-457.[PubMed]