假性淋巴瘤肝脏11咬ppt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+。 BCR：IgH基因重排：Fr2A+Fr2B：阴性；Fr3A：