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中华临床医师杂志(电子版) ›› 2020, Vol. 14 ›› Issue (06) : 469 -474. doi: 10.3877/cma.j.issn.1674-0785.2020.06.014

所属专题: 经典病例 文献

病例报告

乙型肝炎病毒携带者肝内胆管细胞癌肝门淋巴结转移一例
马晨辉1, 牛立鹏1, 温军业1, 郭怀斌1, 张万星1,()   
  1. 1. 050000 石家庄,河北省人民医院肝胆外科
  • 收稿日期:2020-02-13 出版日期:2020-06-15
  • 通信作者: 张万星
  • 基金资助:
    河北省医学科学研究重点课题(20190382)

Hepatic portal lymph node metastasis of intrahepatic cholangiocarcinoma in a hepatitis B virus carrier

Chenhui Ma1, Lipeng Niu1, Junye Wen1   

  • Received:2020-02-13 Published:2020-06-15
引用本文:

马晨辉, 牛立鹏, 温军业, 郭怀斌, 张万星. 乙型肝炎病毒携带者肝内胆管细胞癌肝门淋巴结转移一例[J]. 中华临床医师杂志(电子版), 2020, 14(06): 469-474.

Chenhui Ma, Lipeng Niu, Junye Wen. Hepatic portal lymph node metastasis of intrahepatic cholangiocarcinoma in a hepatitis B virus carrier[J]. Chinese Journal of Clinicians(Electronic Edition), 2020, 14(06): 469-474.

图1 肝超声造影 肝左叶被膜下可探及一低回声区,边界不清,范围约37.9 mm×26.0 mm;脏器声学造影:注入造影剂后13 s肝内出现微泡,图a为动脉期,病灶高增强,范围约45.3 mm×34.4 mm;图b为门静脉期,病灶低增强;图c为延迟期,病灶低增强
图2 肝左叶MRI扫描 大小约3.7 cm×2.7 cm×3.0 cm肿物,T1WI稍低、T2WI混杂高信号、弥散加权成像高信号;图a为弥散加权成像,图b为动脉期,图c为静脉期,图d为延迟期;动脉期边缘明显不均匀强化,中间呈混杂信号影,增强曲线呈平台型;肝胆期中心高边缘低信号;门静脉期及肝静脉未见充盈缺损
图3 肝门部肿块磁共振影像 大小约3.0 cm×2.4 cm×4.9 cm;增强扫描:环形强化;图a为弥散加权成像,图b为动脉期,图c为静脉期,图d为延迟期
图4 肝占位PET/CT扫描图 肝左叶、肝门部高代谢影,余部位未见明显转移病灶
图5 穿刺病理图 图a为网状纤维染色,×200;图b为HE染色,×100
图6 肿瘤大体标本 肿瘤位于肝Ⅵb段,质硬,被膜完整,肿瘤剖面呈灰色纤维样组织,大小约4.0 cm×2.5 cm×2.0 cm
图7 术后病理图片(×400) 图a为免疫组化染色,图b为HE染色,显示浸润性生长
图8 2次磁共振复查增强扫描各期均无明显强化图a为2018年11月27日检查结果,图b为2019年4月3日检查结果
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