摘要
目的：提高对肝脏上皮样血管内皮瘤（EHE）的影像及病理学认识。方法：回顾性分析4例肝EHE的临床及影像学表现，所有病例经过穿刺活检或手术病理学证实。其中3例行CT平扫及增强扫描， 1例同时行CT平扫和MRI平扫及增强扫描。结果：CT平扫示肝脏单发或多发类圆形低密度灶，边界清楚，增强扫描呈渐进性轻度强化，中央更低密度区无强化。MRI显示肝内多个环形病灶，实质部分呈稍长T1、稍长T2信号，中央部分呈稍短T1长T2信号，增强扫描示环形实质部分强化、延时扫描示病灶持续强化，结节中央无强化。组织学示肿瘤中部分区域纤维结缔组织增生，其间可见上皮样细胞，呈印戒状。免疫组化，CD34、CD31、Ⅷ因子相关抗原均呈阳性。结论：肝脏EHE的影像表现具有一定的特征性，表现为单发或多发病灶，病灶之间可相互融合，多发位于肝包膜下，可见“包膜回缩征”，增强扫描呈渐进性强化，部分病灶可见“棒棒糖征”。
Abstract
Objective: To improve the understanding of imaging and pathologic findings of hepatic epithelioid hemangioendothelioma(EHE). Methods: The clinical imaging findings of four cases with hepatic EHE were retrospectively analyzed. All cases were confirmed by biopsy or surgical pathology. Three cases underwent plain and contrast-enhanced CT scans, one case underwent CT and MRI examination. Results: CT images showed single or multiple quasi-circular hypodense lesions, clear boundary, progressive mild enhancement, no enhancement in the central area． MRI images showed multiple ring shaped nodules in liver, the essence of the lesions had slightly longer T1 and T2 relaxation times and ring-shaped continued enhancement, the central of the lesions had slightly short T1 relaxation times and very long T2 relaxation times, no enhancement. Histology results revealed proliferation of abnormal fibrous tissue which were scattered with epithelioid cells and signet ring-like structure． By immunohistochemical staining, all cases were positive for CD34, CD31 and factor Ⅷ-related antigen． Conclusion: The imaging findings of hepatic EHE has certain characteristics, which manifested as single or multiple lesions, the lesion can be mutual confluence and located in the subcapsular, together with “capsular retraction sign”．Enhanced scan showed progressive enhancement, together with “lollipop sign”.
关键词
肝肿瘤 /
血管内皮瘤 /
上皮样 /
体层摄影术 /
螺旋计算机 /
磁共振成像
Key words
Liver neoplasms /
Hemangioendothelioma /
epithelioid /
Tomography /
spiral computed /
Magnetic resonance imaging
阎 岚;闫康鹏.
肝脏上皮样血管内皮瘤的影像特征及病理基础[J]. 中国临床医学影像杂志. 2015, 26(9): 642-645
YAN Lan;YAN Kang-peng.
Imaging and pathologic findings of hepatic epithelioid hemangioendothelioma[J]. Journal of China Clinic Medical Imaging. 2015, 26(9): 642-645
中图分类号：
Ｒ735.7
R814.42
Ｒ445.2
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