- 期刊
Multiple Hepatic Angiomyolipomas: Report of a Case
肝臟多發性血管肌肉脂肪瘤：一病例報告
摘要
肝臟血管肌肉脂肪瘤是一種少見良性組織腫瘤，血管肌肉脂肪瘤源自脂肪細胞、平滑肌肉纖維和血管之不同程度組合。本文報告一例五十歲女性患者因右上腹疼痛，經腹部超音波檢查有膽囊結石及多發性肝腫瘤，患者經腹腔鏡手術切除膽囊結石時，並同時作肝臟腫瘤切片檢查，發現臨床上少見之肝臟多發性血管肌肉脂肪瘤。患者並未合併腎臟血管肌肉脂肪瘤及結節狀硬化。腹部疼痛因切除膽囊而改善，患者缺鐵性貧血並非因為胃腸道漏失引起，以口服鐵劑治療貧血並無效，但注射鐵劑則有改善。腹腔鏡及病理檢查證實血管肌肉脂防瘤，腫瘤肌肉細胞為HMB-45免疫組織化學染色陽性。臺灣是B型肝炎及肝細胞癌高盛行地區，因此任何肝臟腫瘤皆應排除肝細胞癌之可能性。
並列摘要
Hepatic angiomyolipoma is an uncommon benign mesenchymal neoplasm with a high content of fat cells, variable proportions of smooth muscle fibers and blood vessels. We present a rare case of multiple hepatic angiomyolipomas. A 50-year-old lady had gall stones related right upper quadrant abdominal pain as well as multiple bright liver tumors. Patient underwent laparoscopic cholecystectomy and diagnostic liver wedge biopsy. Histologic findings of liver tumors showed fat cells, blood vessels and epitheloid smooth-muscle cells. The epitheloid smooth-muscle cells were positive for HMB-45 staining. Intensive studies did not show any renal angiomyolipoma and tuberous sclerosis. The abdominal pain had been improved after cholecystectomy. Our patient had also iron deficiency anemia. Upper endoscopy, colonoscopy and small intestinal series did not show any evidence of intestinal blood loss. Her hemoglobin did not respond to iron-supplement therapy. Iron malabsorption might be the cause of iron deficiency anemia.
延伸閱讀
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