肝海绵状血管瘤临床特点及病理分析

Clinical Characteristics and Pathological Analysis of Hepatic Cavernous Hemangioma

目的探讨肝海绵状血管瘤的临床病理特征。方法收集2014年1月~2017年4月我院存档的25例肝海绵状血管瘤石蜡标本,行HE染色后观察其病理形态,并结合患者病史和影像学资料总结肝海绵状血管瘤的临床病理特征。结果共25例肝海绵状血管瘤标本,其中女性18例,男性7例;病灶位于左肝叶10例,右肝叶12例,左、右肝叶均有者3例,分布无明显规律;血管瘤单发20例,多发5例;病灶最大径4~10cm。CT平扫表现为肝实质内圆形、类圆形或不规则形低密度影,边缘尚清楚;动脉期呈结节状强化;门静脉期强化向心性强化;平衡期和延迟期肿瘤持续向心性强化,且强化程度减低。MRI表现为T1WI呈均匀低信号,T2WI呈均匀高信号,病灶边缘清晰。肝海绵状血管瘤表现为质地柔软的肿物,切面无包膜,呈腔隙状;病变与周围肝组织分界清楚,由大量不规则形扩张的血管组成,管腔大小、形状不一。结论肝海绵状血管瘤临床表现不明显,以女性多见,单发为主;病变主要由大小不等的异常血管腔组成,管腔内衬单层扁平内皮细胞,周围环绕纤维组织。

Objective To explore the clinicopathological features of hepatic cavernous hemangioma.Methods 25 specimens of hepatic cavernous hemangioma were collected from January 2014 to April 2017.The pathological morphology was observed after HE staining.The clinical and clinical data of patients with hepatic cavernous hemangioma were summarized.Pathological features.Results A total of 25 specimens of hepatic cavernous hemangioma,including 18 females and 7 males;the lesions were located in the left hepatic lobe in 10 cases,the right hepatic lobe in 12 cases,and the left and right hepatic lobe in 3 cases,with no obvious distribution;There were 20 cases of single tumor and 5 cases of multiple cases.The maximum diameter of the lesion was 4~10 cm.CT plain scan showed a round,round or irregular lowdensity shadow in the liver parenchyma with clear edges;nodular enhancement in the arterial phase;intensive cardiac enhancement in the portal vein;continuous centripetal in the balanced and delayed phases Strengthened and reduced in intensity.MRI showed a uniform low signal on T1WI,a uniform high signal on T2WI,and a clear edge of the lesion.The hepatic cavernous hemangioma is characterized by a soft mass of the tumor.The cut surface has no capsule and is lacunar.The lesion is clearly separated from the surrounding liver tissue.It consists of a large number of irregularly shaped vessels,and the lumen size and shape are different.Conclusion The clinical manifestations of hepatic cavernous hemangioma are not obvious.They are more common in women and single-shot.The lesions are mainly composed of abnormal vascular cavities of different sizes.The lumen is lined with a single layer of flat endothelial cells surrounded by fibrous tissue.