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肝脏反应性淋巴细胞增生:一个病例报告显示特征性结节和周结节增强
Hirohito Osanai1, Kazuto Kozaka1, Norihide Yoneda1
1Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan.
Radiology case reports
|March 5, 2024
概括
在患有原发性胆道胆道炎的患者中诊断肝反应性淋巴细胞增生 (RLH) 可能具有挑战性. 关键的成像发现包括一个单一的,均的结节,具有特定的增强模式和扩散特征,有助于与恶性瘤的区分.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 放射学 放射学是一门学科.
- 病理学 病理学 病理学
背景情况:
- 初级胆道胆炎 (PBC) 可能伴有偶尔的肝结节.
- 区分良性肝病变与恶性瘤对于患者管理至关重要.
- 肝反应性淋巴细胞增生 (RLH) 由于与恶性瘤的成像特征重叠而构成诊断挑战.
研究的目的:
- 描述肝脏RLH的成像特征.
- 要突出帮助区分RLH与恶性肝病变的关键特征.
- 为特征性成像发现提出新的术语.
主要方法:
- 一个53岁的女性患有PBC和肝结节的病例介绍.
- 多模式成像评估,包括超声波,动态CT,MRI,动脉图像期间CT,CT肝动脉图 (CTHA) 和18F-FDG-PET/CT.
- 通过切除活检进行组织病理学诊断.
主要成果:
- 肝结节的尺寸为18毫米,是均的和低声的.
- 典型的发现包括轻微的动脉相增强,明显的扩散加权图像超强度与周围节性超强度 (彗星和彗星尾的外观),以及门外 perfusion 缺陷.
- CTHA揭示了结节和形的周结节增强,称为"彗星和彗星尾的外观".
结论:
- 肝脏RLH可以在成像上模仿恶性肝脏瘤.
- 在CTHA上,围块早期增强和在DWI上,围块高强度是关键的区别特征.
- 拟议的"彗星和彗星尾的外观"可能有助于诊断肝脏RLH.
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