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中华肝脏外科手术学电子杂志

中华肝脏外科手术学电子杂志 ›› 2015, Vol. 04 ›› Issue (02) : 109 -112. doi: 10.3877/cma.j.issn.2095-3232.2015.02.012

所属专题： 文献；

临床研究

肝滤泡树突状细胞肉瘤一例并文献复习
张先舟1, 聂常富1, 韩风1,†(), 周进学1, 邱大鹏1, 李庆军1, 蒙博1, 白睿华2, 王涛1, 庞春1, 庄浩1   
  1. 1. 450008　郑州大学附属肿瘤医院肝胆胰外科
    2. 450008　郑州大学附属肿瘤医院病理科
  • 收稿日期:2014-12-02 出版日期:2015-04-10
  • 通信作者: 韩风
  • 基金资助:
    河南省医学科技公关计划项目(201404040)

Hepatic follicular dentritic cell sarcoma:a case report and literature review

Xianzhou Zhang1, Changfu Nie1, Feng Han1,†(), Jinxue Zhou1, Dapeng Qiu1, Qingjun Li1, Bo Meng1, Ruihua Bai2, Tao Wang1, Chun Pang1, Hao Zhuang1   

  1. 1. Department of Hepatopancreatobiliary Surgery, Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou 450008, China
    2. Department of Pathology, Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou 450008, China
  • Received:2014-12-02 Published:2015-04-10
  • Corresponding author: Feng Han
  • About author:
    Corresponding author: Han Feng,Email:
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引用本文：

张先舟, 聂常富, 韩风, 周进学, 邱大鹏, 李庆军, 蒙博, 白睿华, 王涛, 庞春, 庄浩. 肝滤泡树突状细胞肉瘤一例并文献复习[J]. 中华肝脏外科手术学电子杂志, 2015, 04(02): 109-112.

Xianzhou Zhang, Changfu Nie, Feng Han, Jinxue Zhou, Dapeng Qiu, Qingjun Li, Bo Meng, Ruihua Bai, Tao Wang, Chun Pang, Hao Zhuang. Hepatic follicular dentritic cell sarcoma:a case report and literature review[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2015, 04(02): 109-112.

目的

探讨肝滤泡树突状细胞肉瘤（FDCS）的临床特点。

方法

回顾性分析2004年郑州大学附属肿瘤医院收治的1例肝FDCS患者临床资料。患者已签署知情同意书，符合医学伦理学规定。患者女，49岁。因上腹部疼痛1月余入院。体检示剑突下可触及12cm×12cm肿块，质硬，活动度差，压痛。实验室检查基本正常。CT平扫示肝左叶实性占位，直径约20 cm；增强扫描示动脉期肿瘤不规则强化，延迟期强化减退，肿瘤呈低密度灶。临床诊断为原发性肝癌。

结果

经过积极术前准备，于2004年8月31日在气管插管全身麻醉下行左半肝切除术。术中见肿瘤位于肝左外叶，大小约23cm×20cm，质韧，瘤旁子灶形成，腹腔、盆腔内及腹膜均未见明显转移灶。术后病理学检查示炎性假瘤样FDCS，免疫组化法检查示CD21、CD23、CD35，波形蛋白（VIM）阳性。患者分别于2006年至2014年多次于肝脏、腹腔、胸壁等处发现肿瘤复发转移并行切除术。目前患者病情稳定，定期随访，至投稿日期未见复发或转移。

结论

肝FDCS是一种极为罕见的疾病，确诊依赖于病理学检查结果。手术切除肿瘤是可靠的治疗手段，预后较好。

关键词: 肝肿瘤, 树突状细胞肉瘤，滤泡, 肝切除术, 预后
Objective

To investigate the clinical features of hepatic follicular dentritic cell sarcoma (FDCS).

Methods

Clinical data of a patient with hepatic FDCS treated in Cancer Hospital Affiliated to Zhengzhou University in 2004 were retrospectively analyzed. The informed consent of the patient was obtained and the local ethical committee approval had been received. The patient, female, 49-year-old, was admitted to the hospital for the complaint of abdominal pain for 1 month . A 12 cm×12 cm in diameter, hard, poor activity tumor was found below xiphoid by physical examination. Abdominal tenderness was positive and laboratory examinations were essentially normal. CT scan showed a 20 cm in diameter solid lesion in the left lobe of liver. The tumor was observed irregularly enhanced in the arterial phase by enhanced CT scan. The enhancement faded away in the delayed phase, and the tumor revealed a low-density lesion. The initial diagnosis was primary liver cancer.

Results

After an active preoperative preparation, the patient underwent left lobectomy under endotracheal general anesthesia on August 31, 2004. A tough tumor measuring 23 cm×20 cm in diameter was found in the left lobe of liver during the surgery. Nodule foci were found beside the tumor and no obvious metastasis was found within the abdomen, pelvic cavity and peritonium. Postoperative pathological examination indicated inflammatory pseudotumor FDCS and Immunohistochemistry indicated positive CD21, CD23, CD35 and vimentin (VIM). Tumor recurrence and matastasis were observed in the liver, abdomen cavity and chest wall etc. repeatedly and was resected during 2006 to 2014. The patient is currently in stable condition and no recurrence or metastasis was observed during regular follow-up till submission date.

Conclusions

Hepatic FDCS is a very rare disease. The diagnosis relies on the results of pathological examination. Surgical resection is a reliable treatment and the prognosis is favorable.

Key words: Liver neoplasms, Dendritic cell sarcoma, follicular, Hepatectomy, Prognosis
图1 肝滤泡树突状细胞肉瘤患者增强CT扫描图像
图2 肝滤泡树突状细胞肉瘤组织病理切片
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