| 许飞,周纯武,李忱瑞,宋艳.肝胆管囊腺瘤和囊腺癌的临床病理及影像学诊断[J].中国医学影像技术,2012,28(4):731~734 |
| 肝胆管囊腺瘤和囊腺癌的临床病理及影像学诊断 |
| Clinical pathological and imaging diagnosis of hepatic biliary cystadenoma and cystadenocarcinoma |
| 投稿时间：2011-12-08 修订日期：2012-01-06 |
| DOI： |
| 中文关键词: 肝肿瘤 胆管 囊腺瘤 囊腺癌 诊断显像 |
| 英文关键词:Liver neoplasms Bile ducts Cystadenoma Cystadenocarcinoma Diagnostic imaging |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨肝胆管囊腺瘤和囊腺癌的临床、病理及综合影像学表现。 方法 回顾性分析经手术及病理证实的11例肝胆管囊腺瘤和囊腺癌患者的临床、病理及影像学表现。 结果 11例患者中,肝胆管囊腺瘤6例,囊腺癌5例。4例有上腹部不适、胀痛等临床症状。免疫组化:囊腺癌患者CEA、CK7、CK19阳性表达;囊腺癌肿瘤间质Vim、Actin和PR标记阳性。影像学表现:9例位于肝左叶,8例为多房囊性或囊实性肿物,7例肿物周边胆管扩张。肝胆管囊腺瘤5例边界规整,囊内间隔多薄而规整,无或较小囊壁及间隔结节,CDFI未见明显血流信号,CT、MR增强无明显强化;肝胆管囊腺癌4例边界不规整,囊内间隔多为厚分隔,囊壁及间隔结节较大,CDFI可见血流信号,增强扫描呈不均匀强化。 结论 肝多房囊性或囊实性肿物、囊壁及间隔结节、肿物周边胆管扩张征象有助于诊断肝胆管囊腺瘤和囊腺癌。 |
| 英文摘要: |
| Objective To explore the clinical pathological and imaging findings of hepatic biliary cystadenoma and cystadenocarcinoma. Methods The clinical, pathological and imaging findings of 11 patients with hepatic biliary cystadenoma or cystadenocarcinoma confirmed with operation and pathology were analyzed retrospectively. Results Among 11 patients, there were 6 biliary cystadenoma and 5 cystadenocarcinoma. Upper abdominal discomfort and distending pain occurred in 4 patients. Patients with cystadenocarcinoma showed positive CEA, CK7 and CK19, while patients with cystadenocarcinoma stromal cells showed positive Vim, Actin and PR. Lesions located at the left lobe in 9 patients, multilocular cystic or cystic-solid tumors were found in 8 patients and upstream bile duct dilatation in 7 patients. As for biliary cystadenoma, 5 patients had regular borders, thin septum, without or with small mural nodules within the lesions. There was no vascular signal with CDFI in biliary cystadenoma patients, nor enhancement in CT and MR. As for biliary cystadenocarcinoma, lesions in 4 patients had irregular borders, thick septum, large mural nodules within the lesion, some or none vascular signal in CDFI. Heterogeneous enhancement could be observed in CT and MR. Conclusion Features including hepatic multilocular cystic or cystic-solid lesion, mural nodules within the lesion, upstream bile duct dilatation, etc. are helpful to the diagnosis of hepatic biliary cystadenoma and cystadenocarcinoma. |
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