肝脏上皮样血管内皮瘤1例分析并文献回顾

Hepatic epithelioid hemangioendothelioma:a case report and review of literature

目的探讨肝脏上皮样血管内皮瘤的临床病理、影像学表现及治疗。方法分析我院一例经病理证实的肝脏上皮样血管内皮瘤的临床表现、影像表现、病理组织特征,并进行文献相关回顾,探讨该罕见肿瘤的临床、影像、病理特征及治疗方案。结果肝脏上皮样血管内皮瘤的临床表现特异性差,影像表现为低密度,文献病例存在“包膜回缩征”和“棒棒糖征”,强化特征随肿瘤大小变化,病理表现为上皮样细胞等细胞组成,呈条索状、巢状或腺样排列,免疫组化CD31、CD34阳性,治疗以肝肿物切除与肝移植手术为主。结论肝脏上皮样血管内皮瘤临床、影像表现特异性差,病理组化是确诊的方法,以手术治疗为主,在临床诊治中应予以重视。

Objective To investigate the clinicopathological features,imaging features and treatment of hepatic epithelioid hemangioendothelioma.Methods A case of hepatic epithelioid hemangioendotheli⁃oma confirmed by pathology in our hospital was analyzed in terms of clinical manifestations,imaging fea⁃tures and histopathological features.Literature review was conducted to explore the clinical,imaging,pathological features and the treatment of this rare tumor.Results The clinical manifestations of hepatic epithelioid hemangioendothelioma were poor,and the imaging features were that the tumor was low densi⁃ty.There were“capsular retraction sign”and“lollipop sign”in other literature.The enhancement charac⁃teristics varied with the size of the tumors.The pathological features were that the tumor was composed of epithelioid cells,which were arranged in strips,nests or adenoids.Immunohistochemical CD31 and CD34 were positive.Liver tumors resection and liver transplantation were the treatment methods.Conclu⁃sion The clinical manifestations and imaging features of hepatic epithelioid hemangioendothelioma were poor.Pathological histochemistry was the method to make a definitive diagnosis.Surgical treatment is the main method of treatment.HEHE should be paid attention to in clinical diagnosis and treatment.