假性淋巴瘤肝脏11 课件.pptVIP

Imaging findings suggested HCC, although no other hypervascular tumor could be excluded. A right posterior segmentectomy was performed. * Macroscopically, the lesion in segment 7 was white and hard with clear margins. Microscopically, the lesion consisted of a nodular lymphoid infiltrate with germinal centers * Macroscopically, the lesion in segment 7 was white and hard with clear margins. Microscopically,the lesion consisted of a nodular lymphoid infiltrate with germinal centers In situ hybridization revealed no significant difference between the numbers of cells positive for kappa-chain and lambda-chain CD3(+) T-cells CD20(+) B-cells Stained for κ light chains Stained for λ light chains * The patient had an uneventful postoperative course and has shown no sign of recurrence for 11 M. * Summary HPL should be considered in the differential diagnosis of small hepatic tumors (20 mm), especially when a single hypovascular tumor is found in a female patient who associated with either autoimmune disease or chronic liver disease,and the patient has no risk factors of hepatocellular carcinoma. * eWorldView Image * A case of hepatic pseudolymphoma Liu chenhan Department of radiology, Sir Run Run Shaw Hospital * CASE:1443371 F,64Y，体检发现肝脏肿物半月余。 症状、体征（-） 既往：肝Ⅳ段血管瘤 辅检：LAB肿瘤女-6：(2014-08-01),癌胚抗原CEA：5.36ng/ml(0-5ng/ml)；肝酶指标（-） 乙肝表面抗原：117 IU/ml 乙肝核心抗体IgG：13.36 COI * 腹部B超:左肝外叶低弱回声结节，建议超声造影； 胃镜：慢性轻度浅表性炎，灶性肠化，幽门螺杆菌：阴性 肠镜：（-） * * eWorldView Image * eWorldView Image * CT:左肝II段边缘可疑稍低密度灶，请结合其它检查或复查。 MR:左肝外侧叶占位，恶性病灶不能排除，转移？或其他。 * 腹腔镜左肝肿块切除+术中冰冻 术中未见明显腹水，肝脏无明显结节性改变，左肝外侧叶可见一大小约2cm肿块，略突出于肝脏表面，质软，边界尚清，剖开肿瘤，切面灰黄色，送术中冰冻提示：淋巴细胞增生，淋巴瘤待排。??? * 冰冻送检肝组织一块， 3.8*3*1.5cm，剖面见一灰白结节，1.7*1.5cm，镜示结节内淋巴组织增生，淋巴滤泡形成，生发中心可见，大小不等，局部伴小血管增生，结节周围围绕以不连续的纤维组织包膜，包膜局部见淋巴组织浸润，周围肝组织汇管区内亦可见成片淋巴细胞浸润。免疫组化（B片）：CD3 CD20 CD5 CD10 CD43 CD15 CD21 CD23 CD30 Bcl2 Bcl6 Kappa Lambda Ki67：未见异常表达，EBER：－，D240：内皮细胞+。 BC