Analysisof16casesmisdiagnosed-临床与病理杂志.PDF

临床与病理杂志 2015, 35(4) J Clin Path ol R e s 615 doi: 10.3978/j.issn.2095-6959.2015.04.019 ·论著 · View this article at: /10.3978/j.issn.2095-6959.2015.04.019 16例肝脏未分化性胚胎性肉瘤术前误诊分析 李妍卓，蔡权宇，贾宁阳，陈栋，陆伦，程红岩 (第二军医大学附属东方肝胆外科医院放射科，上海 200438) [摘　要] 目的：探讨肝脏未分化性胚胎性肉瘤 (undifferentiated embryonal sarcoma of the liver ，UESL) 的临床特 点，加深对该病的认识，提高术前诊断准确性。方法：回顾性分析16例经手术病理证实、术前误诊 UESL患者的临床、影像及病理资料，并对比分析。 结果：16例患者中诊断为原发性肝癌9例，肝母 细胞瘤3例，肝内恶性占位4 例。 12例以腹痛不适就诊；超声显示实性为主肿瘤，而 CT及MRI 呈囊 性为主的肿瘤，瘤内成分混杂；增强后病灶内囊壁下软组织、分隔及边缘可见强化。术后病理见 肿瘤切面呈囊实性，内见不同程度出血坏死、凝胶样区域和肿瘤组织，癌细胞间可见特征性嗜酸 性小体。 结论：未分化胚胎性肉瘤临床罕见，临床资料无明显特异性，超声与 CT 、MRI 表现不一 致性为重要鉴别要点，有助于提高术前诊断率。 [关键词] 肝肿瘤；未分化性胚胎性肉瘤；影像学表现；凝胶样区域 Analysis of 16 cases misdiagnosed undifferentiated embryonal sarcoma of the liver LI Yanzhuo, CAI Quanyu, JIA Ningyang, CHEN Dong, LU Lun, CHENG Hongyan (Department of Radiology, Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Shanghai 200438, China) Abstract Objective: To investigate the clinical features of undifferentiated embryonal sarcoma of the liver (UESL) to improve its preoperative diagnostic accuracy. Methods: Retrospectively analysis the clinical, imaging and histopathologic findings of 16 cases preoperatively misdiagnosed UESL which were all pathologically confirmed. Results: Among these 16 cases, clinically diagnosed primary liver carcinoma 9 cases, hepatoblastoma 3 cases, malignant hepatic tumor 4 cases. Twelve patients mainly presented abdominal discomfort. Sonograms revealed predomi