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首页> 外文期刊>Surgical Case Reports >Hepatic angiomyolipoma: differential diagnosis from other liver tumors in a special reference to vascular imaging - importance of early drainage vein
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Hepatic angiomyolipoma: differential diagnosis from other liver tumors in a special reference to vascular imaging - importance of early drainage vein

机译：肝血管平滑肌脂肪瘤：与其他肝脏肿瘤的鉴别诊断，特别涉及血管成像-早期引流静脉的重要性

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A 51-year-old female had been diagnosed with a hemangioma in the hepatic segment 6 (S6). After a 6-year follow-up, enlargement of the tumor was detected. The tumor was clearly enhanced in the arterial phase, and the enhancement remained in the portal phase on computed tomography (CT). Although the primary differential diagnosis on CT was hepatocellular carcinoma (HCC), we worried about the possibility of other vessel system tumors because the tumor remained to be enhanced at the portal phase for HCC and all tumor markers of HCC were negative. We performed angiography to determine the tumor nature and to seek other tumors. Angiography showed tumor stain at the hepatic S6 with an early obvious drainage vein from the tumor flowing through the right hepatic vein into the inferior vena cava. In addition to tumor stain and the drainage vein, there were many small poolings of contrast medium in the whole liver, which were suspected as dilatation of the hepatic peripheral artery. We suspected the tumor as a benign tumor such as hepatocellular adenoma or focal nodular hyperplasia, but the possibility of HCC could not be ruled out. Hepatic posterior sectionectomy was done to completely remove the drainage vein with the tumor. Intraoperative histological examination revealed the tumor as not malignant and not HCC. Later, immunohistochemical analysis uncovered that the tumor had high expression of HMB-45 and, therefore, the final diagnosis was angiomyolipoma. We think that detecting an early drainage vein from the tumor would be a key point for diagnosing hepatic angiomyolipoma
机译：一名51岁的女性被诊断出肝段6（S6）患有血管瘤。经过6年的随访，发现了肿瘤的扩大。肿瘤在动脉期明显增强，而在计算机断层扫描（CT）上，增强仍保留在门脉期。尽管CT的主要鉴别诊断是肝细胞癌（HCC），但我们担心其他血管系统肿瘤的可能性，因为该肿瘤在肝癌门脉期仍需增强，并且所有肝癌标志物均为阴性。我们进行了血管造影以确定肿瘤的性质并寻找其他肿瘤。血管造影显示肝S6处有肿瘤染色，早期明显的引流静脉从肿瘤流过右肝静脉进入下腔静脉。除了肿瘤染色和引流静脉外，整个肝脏中还有许多小的造影剂汇聚物，被怀疑是肝周围动脉扩张。我们怀疑该肿瘤为良性肿瘤，例如肝细胞腺瘤或局灶性结节性增生，但不能排除肝癌的可能性。进行肝后切除术以完全清除肿瘤引流静脉。术中组织学检查显示该肿瘤为非恶性和非肝癌。后来，免疫组织化学分析发现该肿瘤高表达HMB-45，因此，最终诊断为血管平滑肌脂肪瘤。我们认为从肿瘤中发现早期引流静脉将是诊断肝血管平滑肌脂肪瘤的关键

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