妊娠合并肝血管肉瘤破裂1例报道及文献回顾

Ruptured hepatic angiosarcoma complicated by pregnancy:one case report and literature review

目的:报道1例妊娠合并肝脏血管肉瘤破裂,结合文献探讨其临床病理特征、诊断及鉴别诊断要点。方法:对1例妊娠合并肝血管肉瘤进行临床病理分析及免疫组化观察。结果:肝血管肉瘤无特殊临床表现及影像学检查,镜下肿瘤组织由大小不一、互相吻合管腔构成,部分区域瘤细胞沿肝窦浸润性生长,管腔细胞异型性明显,核分裂象易见。免疫组化结果:肿瘤细胞表达CD31、CD34、FACTOR VⅢ。结论:肝血管肉瘤为罕见疾病,合并妊娠未见报道。具有独特的临床病理特点,诊断及鉴别诊断主要依靠病理组织学及免疫组化,治疗以手术切除为主,必要时进行化疗及放疗,胎儿应结合孕期综合处理。

Objective：To report one case of ruptured hepatic angiosarcoma complicated by pregnancy and discuss its clinical and histopathologic features,as well as diagnosis and differential diagnosis.Methods：The case was analyzed by history review,histology and immunohistochemistry.Results：Patients with hepatic angiosarcoma had no special clinical and physical sign.Microscopically,the tumor was composed of anastomosis vascular with different size.The tumor cells have invasive growth way along liver sinus in some areas.Tumor cells have obvious atypia and high mitotic index.The tumor cells showed positive immunohistochemical reaction to CD31,CD34 and factor VIII.Conclusion：Hepatic angiosarcoma is rare tumor.There is no report of hepatic angiosarcoma complicated by pregnancy.It has no special clinico-pathological features.The diagnosis and differential diagnosis rely mainly on histopathological and immunohistochemical findings.The surgical excision is the first-choice treatment.Chemotherapy and radiotherapy can be used when necessary.Fetal care should be considered comprehensively during the maternal treatment.