肝淋巴管瘤1例报道

A case report of hepatic lymphangioma

目的探究此罕见肝脏肿瘤的特征,提高对本病的认识,提高诊断准确率,探索本疾病的规范诊疗方法。方法回顾性分析我中心1例采用解剖性肝段切除的肝脏淋巴管瘤的术前临床资料,术后免疫组化标记物Ki67、CD31、CD34、CK19等评判此例肿瘤良恶性,术后复查血清学标记物、肝脏彩超、CT、MRI等评估患者的预后及肿瘤复发情况。结果此例患者入院血常规、生化检查及肿瘤学标志物均在正常范围,无乙肝病史,术前诊断为肝S6段囊腺瘤,采用肝S6段肝肿瘤切除+胆囊切除术,术后免疫组化显示CK(-),CD34(+),CD31(+),Ki67(<1%),考虑为淋巴管瘤可能性大;术后快速康复,无手术相关并发症的发生。截止2022.3.17,规律随访13个月,未见肿瘤复发。结论术后病理结合免疫组化结果显示此例肝淋巴管瘤为良性肿瘤,整个肝段切除为治疗有效手段,近期预后良好,患者的中远期疗效需增加样本量并长期随访。

Objective To explore the characteristics of this rare liver tumor,improve the understanding of this disease,improve the diagnostic accuracy,and explore the standardized diagnosis and treatment methods of this disease.Methods The preoperative clinical data of one case of hepatic lymphangioma with anatomical segmentectomy in our center were retrospectively analyzed.The postoperative immunohis⁃tochemical markers Ki67,CD31,CD34 and CK19 were used to evaluate the benign or malignant tumor of this case.The postoperative serological markers,liver ultrasound,CT and MRI were reviewed to evalu⁃ate the prognosis and tumor recurrence of the patient,and to explore the curative effect of the treatment method.Results The blood routine examination,biochemical examination and tumor markers of this patient were all within the normal range,and there was no history of hepatitis B.The patient was diagnosed as hepatic S6 cystadenoma before operation,and was treated with hepatic S6 tumor resection+cholecys⁃tectomy.The postoperative immunohistochemistry showed CK(-),CD34(+),CD31(+),Ki67,which were considered as lymphangioma.The patient recovered quickly after surgery,and no surgery⁃related complications occurred.As of 2022.3.17 regular follow⁃up was 13 months,no tumor recurrence.Conclusion Postoperative pathology combined with immunohistochemical results show that this case of hepatic lymphangioma is a benign tumor,and total resection of hepatic segment is an effective treatment.The short⁃term prognosis is good.The medium and long⁃term efficacy of the patient needs to increase the sample size and long⁃term follow⁃up.