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巨大肝血管瘤伴弥漫性动脉-门静脉瘘1例报告

周帮健 杨俊 印于 朱晓黎 倪才方 王万胜

引用本文:
Citation:

巨大肝血管瘤伴弥漫性动脉-门静脉瘘1例报告

DOI: 10.3969/j.issn.1001-5256.2023.03.025
伦理学声明:本例报告已获得患者家属知情同意。
利益冲突声明:所有作者均声明不存在利益冲突。
作者贡献声明:周帮健负责收集资料,撰写论文;杨俊、印于、朱晓黎参与修改论文;倪才方、王万胜指导撰写论文并最终定稿。
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    通信作者:

    王万胜,wwsdj2002@163.com (ORCID: 0000-0001-9539-4425)

Massive hepatic hemangioma with diffuse arterioportal fistula: A case report

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    Corresponding author: WANG Wansheng, wwsdj2002@163.com (ORCID: 0000-0001-9539-4425)
  • 图  1  术前影像学检查

    注:a,MR动脉期,肝左叶占位约175 mm×131 mm(黑色箭头),增强病变信号不均;b,门静脉期,病变内未见明显向心性强化;c,冠状位可见瘤体压向腹腔(白色箭头);d,CT动脉期,肝左叶病变中央可见类圆形无强化影(黑色箭头);e,门静脉期病变中央仍呈低密度;f,PET- CT未见明显肝外转移灶。

    Figure  1.  Preoperative imaging examination

    图  2  数字减影血管造影(DSA)检查

    注:a,造影可见瘘口来源于肝左动脉(黑色箭头);b,动脉造影时门静脉全程显影;c,Dyna-CT重建后肝左叶病灶呈低密度(白色箭头)。

    Figure  2.  DSA arteriography

    图  3  术前胃镜检查

    Figure  3.  Preoperative gastroscopy

    图  4  术后病理(HE染色,×100)

    Figure  4.  Postoperative pathology(HE staining, ×100)

    图  5  术后CT检查

    注:a,CT动脉期,左肝切缘可见不均匀强化(黑色箭头),门静脉显影明显;b,门静脉期,左肝切缘仍可见部分强化;c,冠状位可见左肝切缘愈合良好。

    Figure  5.  Postoperative CT

  • [1] Professional Committee of Hemangioma of Liver of Chinese Branch of International Hepatobiliary and Pancreatic Association. Multidisciplinary expert consensus on the diagnosis and treatment of hepatic hemangioma (2019 edition)[J]. J Clin Hepatol, 2019, 35(9): 1928-1932. DOI: 10.3969/j.issn.1001-5256.2019.09.008.

    国际肝胆胰协会中国分会肝血管瘤专业委员会. 肝血管瘤诊断和治疗多学科专家共识(2019版)[J]. 临床肝胆病杂志, 2019, 35(9): 1928-1932. DOI: 10.3969/j.issn.1001-5256.2019.09.008.
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    [4] DU J, CAO MM, LUO HF, et al. Primary hepatic angioendotheliosarcoma with splenic metastasis: a case report[J]. Chin J Pract Surg, 2017, 37(11): 1304-1305. DOI: 10.19538/j.cjps.Issn.1005-2208.2017.11.30.

    杜渐, 曹默默, 罗海峰, 等. 原发性肝脏血管内皮肉瘤伴脾转移1例报告[J]. 中国实用外科杂志, 2017, 37(11): 1304-1305. DOI: 10.19538/j.cjps.Issn.1005-2208.2017.11.30.
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    唐光才. 肝脏血管肉瘤临床CT表现1例[J]. 中国临床医学影像杂志, 2005, 16(1): 11. DOI: 10.3969/j.issn.1008-1062.2005.01.021.
    [6] PICKHARDT PJ, KITCHIN D, LUBNER MG, et al. Primary hepatic angiosarcoma: multi-institutional comprehensive cancer centre review of multiphasic CT and MR imaging in 35 patients[J]. Eur Radiol, 2015, 25(2): 315-322. DOI: 10.1007/s00330-014-3442-0.
    [7] GUZMAN EA, MCCAHILL LE, ROGERS FB. Arterioportal fistulas: introduction of a novel classification with therapeutic implications[J]. J Gastrointest Surg, 2006, 10(4): 543-550. DOI: 10.1016/j.gassur.2005.06.022.
    [8] VAUTHEY JN, TOMCZAK RJ, HELMBERGER T, et al. The arterioportal fistula syndrome: clinicopathologic features, diagnosis, and therapy[J]. Gastroenterology, 1997, 113(4): 1390-1401. DOI: 10.1053/gast.1997.v113.pm9322535.
    [9] TANAKA A, MORIMOTO T, YAMAMORI T, et al. Atypical liver hemangioma with shunt: long-term follow-up[J]. J Hepatobiliary Pancreat Surg, 2002, 9(6): 750-754. DOI: 10.1007/s005340200104.
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出版历程
  • 收稿日期:  2022-07-05
  • 录用日期:  2022-08-08
  • 出版日期:  2023-03-20
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