中华肝脏外科手术学电子杂志
中華肝髒外科手術學電子雜誌
중화간장외과수술학전자잡지
CHINESE JOURNAL OF HEPATIC SURGERY(ELECTRONIC EDITION)
2015年
2期
109-112
,共4页
张先舟%聂常富%韩风%周进学%邱大鹏%李庆军%蒙博%白睿华%王涛%庞春%庄浩
張先舟%聶常富%韓風%週進學%邱大鵬%李慶軍%矇博%白睿華%王濤%龐春%莊浩
장선주%섭상부%한풍%주진학%구대붕%리경군%몽박%백예화%왕도%방춘%장호
肝肿瘤%树突状细胞肉瘤,滤泡%肝切除术%预后
肝腫瘤%樹突狀細胞肉瘤,濾泡%肝切除術%預後
간종류%수돌상세포육류,려포%간절제술%예후
Liver neoplasms%Dendritic cell sarcoma,follicular%Hepatectomy%Prognosis
目的：探讨肝滤泡树突状细胞肉瘤（FDCS）的临床特点。方法回顾性分析2004年郑州大学附属肿瘤医院收治的1例肝FDCS患者临床资料。患者已签署知情同意书，符合医学伦理学规定。患者女，49岁。因上腹部疼痛1月余入院。体检示剑突下可触及12 cm×12 cm肿块，质硬，活动度差，压痛。实验室检查基本正常。CT平扫示肝左叶实性占位，直径约20 cm；增强扫描示动脉期肿瘤不规则强化，延迟期强化减退，肿瘤呈低密度灶。临床诊断为原发性肝癌。结果经过积极术前准备，于2004年8月31日在气管插管全身麻醉下行左半肝切除术。术中见肿瘤位于肝左外叶，大小约23 cm×20 cm，质韧，瘤旁子灶形成，腹腔、盆腔内及腹膜均未见明显转移灶。术后病理学检查示炎性假瘤样FDCS，免疫组化法检查示CD21、CD23、CD35，波形蛋白（VIM）阳性。患者分别于2006年至2014年多次于肝脏、腹腔、胸壁等处发现肿瘤复发转移并行切除术。目前患者病情稳定，定期随访，至投稿日期未见复发或转移。结论肝FDCS是一种极为罕见的疾病，确诊依赖于病理学检查结果。手术切除肿瘤是可靠的治疗手段，预后较好。
目的：探討肝濾泡樹突狀細胞肉瘤（FDCS）的臨床特點。方法迴顧性分析2004年鄭州大學附屬腫瘤醫院收治的1例肝FDCS患者臨床資料。患者已籤署知情同意書，符閤醫學倫理學規定。患者女，49歲。因上腹部疼痛1月餘入院。體檢示劍突下可觸及12 cm×12 cm腫塊，質硬，活動度差，壓痛。實驗室檢查基本正常。CT平掃示肝左葉實性佔位，直徑約20 cm；增彊掃描示動脈期腫瘤不規則彊化，延遲期彊化減退，腫瘤呈低密度竈。臨床診斷為原髮性肝癌。結果經過積極術前準備，于2004年8月31日在氣管插管全身痳醉下行左半肝切除術。術中見腫瘤位于肝左外葉，大小約23 cm×20 cm，質韌，瘤徬子竈形成，腹腔、盆腔內及腹膜均未見明顯轉移竈。術後病理學檢查示炎性假瘤樣FDCS，免疫組化法檢查示CD21、CD23、CD35，波形蛋白（VIM）暘性。患者分彆于2006年至2014年多次于肝髒、腹腔、胸壁等處髮現腫瘤複髮轉移併行切除術。目前患者病情穩定，定期隨訪，至投稿日期未見複髮或轉移。結論肝FDCS是一種極為罕見的疾病，確診依賴于病理學檢查結果。手術切除腫瘤是可靠的治療手段，預後較好。
목적：탐토간려포수돌상세포육류（FDCS）적림상특점。방법회고성분석2004년정주대학부속종류의원수치적1례간FDCS환자림상자료。환자이첨서지정동의서，부합의학윤리학규정。환자녀，49세。인상복부동통1월여입원。체검시검돌하가촉급12 cm×12 cm종괴，질경，활동도차，압통。실험실검사기본정상。CT평소시간좌협실성점위，직경약20 cm；증강소묘시동맥기종류불규칙강화，연지기강화감퇴，종류정저밀도조。림상진단위원발성간암。결과경과적겁술전준비，우2004년8월31일재기관삽관전신마취하행좌반간절제술。술중견종류위우간좌외협，대소약23 cm×20 cm，질인，류방자조형성，복강、분강내급복막균미견명현전이조。술후병이학검사시염성가류양FDCS，면역조화법검사시CD21、CD23、CD35，파형단백（VIM）양성。환자분별우2006년지2014년다차우간장、복강、흉벽등처발현종류복발전이병행절제술。목전환자병정은정，정기수방，지투고일기미견복발혹전이。결론간FDCS시일충겁위한견적질병，학진의뢰우병이학검사결과。수술절제종류시가고적치료수단，예후교호。
ObjectiveTo investigate the clinical features of hepatic follicular dentritic cell sarcoma (FDCS).MethodsClinical data of a patient with hepatic FDCS treated in Cancer Hospital Affiliated to Zhengzhou University in 2004 were retrospectively analyzed. The informed consent of the patient was obtained and the local ethical committee approval had been received. The patient, female, 49-year-old, was admitted to the hospital for the complaint of abdominal pain for 1 month . A 12 cm×12 cm in diameter, hard, poor activity tumor was found below xiphoid by physical examination. Abdominal tenderness was positive and laboratory examinations were essentially normal. CT scan showed a 20 cm in diameter solid lesion in the left lobe of liver. The tumor was observed irregularly enhanced in the arterial phase by enhanced CT scan. The enhancement faded away in the delayed phase, and the tumor revealed a low-density lesion. The initial diagnosis was primary liver cancer.ResultsAfter an active preoperative preparation, the patient underwent left lobectomy under endotracheal general anesthesia on August 31, 2004. A tough tumor measuring 23 cm×20 cm in diameter was found in the left lobe of liver during the surgery. Nodule foci were found beside the tumor and no obvious metastasis was found within the abdomen, pelvic cavity and peritonium. Postoperative pathological examination indicated inlfammatory pseudotumor FDCS and Immunohistochemistry indicated positive CD21, CD23, CD35 and vimentin (VIM). Tumor recurrence and matastasis were observed in the liver, abdomen cavity and chest wall etc. repeatedly and was resected during 2006 to 2014. The patient is currently in stable condition and no recurrence or metastasis was observed during regular follow-up till submission date. ConclusionsHepatic FDCS is a very rare disease. The diagnosis relies on the results of pathological examination. Surgical resection is a reliable treatment and the prognosis is favorable.
