摘要
目的 回顾原发性肝、胆囊神经内分泌癌 (PHGNC)影像学表现及临床症状。方法 患者 5例 ,男 1例 ,女 4例。长期腹泻 4例 ,药物难以控制 ,其中伴腹痛 2例 ;肿瘤出血 ,导致肝破裂 1例。超声检查 5例 ,CT检查 4例 ,肝动脉造影检查 3例。肿瘤发生在肝脏 3例 ,发生在肝脏及胆囊 1例 ,发生在胆囊 1例。手术证实 3例、活检及尸检证实各 1例。结果 肝内多发肿瘤 3例 ,单发肿瘤 1例。超声表现 :肝内不均匀强回声肿块 2例 ,不均匀低回声肿块 1例 ,内有一些小液化区 ,瘤体彩色血流丰富 ;肝内以囊性为主的巨大囊实性肿块 1例 ;1例胆囊肿瘤表现为胆囊壁隆起性结节 ,无特异性征象。CT表现 :肝脏内不均匀密度肿块 ,增强扫描肿瘤轻度强化 ,瘤内有一些小液化区。肝动脉造影表现 :肿瘤实体部分血流丰富 ,瘤体明显染色 ;巨大囊实性肿瘤表现为瘤内无血管 ,周围血管受压。结论肝神经内分泌癌影像学表现为肝内不均质肿块 ,内部血流丰富 ,肿瘤明显染色 ;肿瘤巨大时可发生出血、坏死、囊性变 ;肿瘤易发生肝内转移 ;肿瘤预后差。胆囊神经内分泌癌表现为胆囊壁隆起性病变 ,无特异性征象。患者常有腹泻、腹痛症状。
Objective To review the imaging appearances and clinical symptoms of primary hepatic and gallbladder neuroendocrine carcinomas (PHGNC). Methods Five patients (4 females and 1 male) were examined. Long-term diarrhea not controlled by drug was found in four patients, and two of them accompanied by abdominal pain. The liver rupture occurred in one case due to the huge tumor bleeding. Five patients were examined by using ultrasonography (US), four patients by CT, and three patients by hepatic angiography. The tumor originated from liver in three cases, from liver and gallbladder in one case, and from gallbladder in one case. The tumors were diagnosed by surgery in 3 cases, by biopsy and by autopsy in 1 case, respectively. Results Multiple hyperechoic inhomogeneous masses in two cases and hypoechoic inhomogeneous masses in one case were revealed, all with some small fluid areas and abundant vessels. A huge cyst-solid tumor was clearly demonstrated by using US. A small mural nodule along the gallbladder wall was displayed by using US in a gallbladder tumor, and it showed no specific sign in the diagnosis. CT findings included hypodense inhomogeneous masses on plain CT scan, and slightly enhanced masses with some small fluid areas after injection of contrast agent. A huge cyst-solid tumor was clearly displayed by CT due to the hemorrhage, necrosis, and cystic changes in the tumor. Hepatoangiography displayed abundant vessels and stain in the solid part of the tumor, and absent vessel in the cystic region of the cyst-solid tumor accompanied by dislocation of surrounding vessels. Conclusion Imaging appearances of the liver tumor were inhomogeneous mass with abundant vessels and tumor stains. Imaging appearances of the gallbladder tumor were raised mural nodule along the gallbladder wall without specific sign in the diagnosis of the tumor. The tumor may develop hemorrhage, necrosis, and cystic changes if it is large enough. PHGNC was prone to hepatic metastases. The patients often presented with diarrhea and abdominal pain.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2003年第12期1143-1147,共5页
Chinese Journal of Radiology
关键词
原发性肝神经内分泌癌
原发性胆囊神经内分泌癌
影像学表现
诊断
超声检查
Liver tumor
Gallbladder tumor
Neuroendocrine carcinoma, carcinoid tumor
Ultrasonography
Tomography, X-ray computed
Angiography
