CT and pathological features of primary hepatic angiosarcoma
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摘要:
目的分析8例原发性肝脏血管肉瘤(PHA)的CT表现及相关病理特点,以提高该病的CT诊断。方法所有病例均经手术病理证实,CT上腹部平扫后行动脉期、门脉期、延迟期增强扫描,观察PHA患者的CT表现。手术切除标本,常规HE染色及免疫组织化学染色,常规显微镜观察。结果 CT平扫8例,5例为巨块型,2例混合型,1例多发结节型。病灶呈不均匀低密度影,中央见更低密度坏死区,其中4例巨块型低密度内见散在小片状高密度影,1例混合型巨块边缘见高密度结节。动脉期7例周边结节状、不规则强化,其中1例中央亦见点絮状强化,1例无明显强化。门脉期及延迟期病灶持续强化,1例病灶始终未见强化。本组9个病灶中5个病灶动脉期及门脉期边缘清晰,与周围正常肝组织界限如同"刀切样"表现。7个病灶外缘在门脉期发现"假包膜"。结论 PHA的CT表现为大片低密度灶内伴不规则坏死区或是散在出血灶,增强检查呈渐进性充填,中央有坏死区,边缘可见"刀切征"和"假包膜征",通过上述特征性表现,有助于提高诊断率。
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关键词:
- 血管肉瘤 /
- 体层摄影术,X线计算机
Abstract:Objective To present the computed tomography (CT) findings and associated pathological features of eight cases of primary hepatic angiosarcoma (PHA) .Methods All cases were confirmed by pathology.After a CT scan of the upper abdomen, all cases of PHA underwent enhanced scans in the arterial phase, portal venous phase, and delayed phase to observe the CT manifestations.The surgical specimens were subjected to conventional hematoxylin- eosin staining and immunohistochemistry and observed under a microscope.Results Of all patients, 5 cases were massive type, 2 cases were mixed type, and 1 case was multiple nodule type.CT scans revealed inhomogeneous low- density lesions, with necrosis of even lower density in the central part.In 4 cases of massive type, scattered high- density small pieces were observed in low- density areas;in one case of mixed type, high- density nodules were observed on the edge of mass.There were 7 cases of peripheral nodular irregular enhancement in the arterial phase, including 1 case with flocculent central enhancement and another with no enhancement.Lesions remained enhanced in the portal venous and delayed phases, but 1 case had no enhancement.Five in 9 lesions had sharp edges in the arterial and portal venous phases, with“sharpen rim perpendicular to pleura”signs at the boundaries with the surrounding normal liver tissue.The outer edges of 7 lesions were found to have“pseudocapsules”in the portal venous phase.Conclusion CT scans showed a large hypodense lesion with irregular necrotic areas or scattered hemorrhage in PHA patients, whist enhanced scans showed a progressive filling and necrotic area in the central part.There could be“sharpen rim perpendicular to pleura”and“pseudocapsule”signs at the edge.It might be helpful to improve the diagnosis through the above characteristic features.
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Key words:
- hemangiosarcoma /
- tomography
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