异位肝组织原发性肝细胞性肝癌的临床病理学观察

Clinicopathological study of ectopic hepatocellular carcinoma

目的探讨异位肝组织原发性肝细胞性肝癌临床病理特点。方法对1例异位肝组织原发性肝细胞性肝癌进行临床病理及免疫组化观察,并复习相关文献。结果患者因血清AFP升高发现肿瘤,核磁共振检查发现肿瘤位于左肋膈角及脾脏之间,手术完整切除后AFP下降,病理诊断为异位肝组织原发性肝细胞性肝癌。结论异位肝组织非常少见,异位肝组织可发生于肝脏常见的相应病变甚至肿瘤;血清AFP升高是异位肝细胞癌的重要临床特征;异位肝细胞需要和转移肝细胞癌及肝样腺癌鉴别。

Objective To investigate the clinicopathological features of ectopic hepatocellular carcinoma.Methods One patients of ectopic hepatocellular carcinoma was analyzed from the clinicopathological features and immunostaining with antibodies HBsAg,HBcAg and AFP.Results The patient was diagnosed as ectopic hepatocellular carcinoma,showing an elevated level of serum alpha-fetoprotein （AFP）.Blood chemistry showed no infection with hepatitis B or C virus and no elevations of tumor markers.Dynamic computed tomography demonstrated a tumor measuring 40 mm in diameter below the left diaphragm just adjacent to the spleen.The tumor showed contrast enhancement in the hepatic arterial phase and became less dense than the liver parenchyma in the portal phase.The patient was diagnosed with ectopic HCC arising in the left diaphragm and laparoscopic surgery was performed.The tumor was located in the left triangular ligament of the liver and had no stalk between the tumor and the liver.The tumor was resected,and the final diagnosis was moderately differentiated ectopic HCC arising in the left triangular ligament of the liver.Conclusion Ectopic liver is rare and is subject to the same lesion as the mother liver,even ectopic hepatocellular carcinoma.Ectopic HCC should be borne in mind as a rare possibility,and measurement of AFP is recommended.