Analysis of clinicopathological findings and imaging features of hepatic epithelioid angiomyolipoma on contrast-enhanced ultrasound

doi:10.3877/cma.j.issn.1674-0793.2017.04.009

Abstract

Abstract:

Objective

To evaluate the clinicopathological findings and imaging features of hepatic epithelioid angiomyolipoma (EAMLs) on contrast-enhanced ultrasound (CEUS).

Methods

From January 2004 to December 2015, six patients with hepatic EAMLs were confirmed by operation in the First Affiliated Hospital of Sun Yat-sen University. The CEUS imaging findings and clinicopathological characteristics of EAMLs were retrospectively analyzed.

Results

The six patients were female, and the mean age was (43.5±12.8) years. All hepatic EAMLs were solitary. No patients had specific symptoms, and laboratory tests were normal in all patients. Under the microscope, the percentage of epithelioid cells varied from 25% to 98%. Immunohistochemical staining showed that the tumour cells were positive for myogenic markers (actin) and melanocytic markers (melan-A, HMB-45). Baseline ultrasound revealed that the maximal diameter of the lesions ranged from 3.1 to 6.5 cm [mean (4.4±1.3) cm], 3 cases were hypo-echoic and 3 were mixed-echoic. CEUS showed that 100.0% (6/6) of homogeneous hyper-enhancement in the arterial phase and 66.7% (4/6) of hypo-enhancement in the late phase. In the portal phase, there were 2 cases (33.3%) with hyper-, 2 with iso-, and 2 with hypo-enhancement, respectively.

Conclusion

The CEUS findings of liver EAMLs are similar to those of hepatocellular carcinoma, and the differential diagnosis should be made for the patients with no history of hepatitis.

Key words: Liver neoplasms, Ultrasonography, Contrast-enhanced ultrasound, Epithelioid angiomyolipoma

Guangliang Huang, Yang Tan, Yuan Lin, Jieyi Ye, Xiaoyan Xie. Analysis of clinicopathological findings and imaging features of hepatic epithelioid angiomyolipoma on contrast-enhanced ultrasound[J]. Chinese Archives of General Surgery(Electronic Edition), 2017, 11(04): 251-254.

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Figures/Tables 3

References 12

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编号	性别	年龄（岁）	临床症状	EC (%)	AD (%)	免疫组织化学结果
编号	性别	年龄（岁）	临床症状	EC (%)	AD (%)	Actin	Melan-A	HMB45	Vimentin	Hepatocyte	S-100
1	女	33	上腹痛	80	0	(+)	(+)	(+)	(+)	(-)	(-)
2	女	54	无	98	0	(+)	(+)	(+)	NA	(-)	(-)
3	女	36	上腹痛	90	5	(+)	(+)	(+)	(+)	(-)	(-)
4	女	44	无	70	10	(+)	(+)	(+)	NA	NA	(+)
5	女	63	无	95	1	(+)	(+)	(+)	(+)	(-)	(-)
6	女	31	无	25	70	(+)	(+)	(+)	(+)	NA	(-)

编号	性别	年龄（岁）	临床症状	EC (%)	AD (%)	免疫组织化学结果
编号	性别	年龄（岁）	临床症状	EC (%)	AD (%)	Actin	Melan-A	HMB45	Vimentin	Hepatocyte	S-100
1	女	33	上腹痛	80	0	(+)	(+)	(+)	(+)	(-)	(-)
2	女	54	无	98	0	(+)	(+)	(+)	NA	(-)	(-)
3	女	36	上腹痛	90	5	(+)	(+)	(+)	(+)	(-)	(-)
4	女	44	无	70	10	(+)	(+)	(+)	NA	NA	(+)
5	女	63	无	95	1	(+)	(+)	(+)	(+)	(-)	(-)
6	女	31	无	25	70	(+)	(+)	(+)	(+)	NA	(-)

编号	肿瘤位置	肿瘤直径(cm)	普通超声			超声造影增强程度
编号	肿瘤位置	肿瘤直径(cm)	形态	回声	血供	动脉期	静脉期	延迟期
1	S8	3.1	不规则形	混合	稀少	高	低	低
2	S4	4.5	类圆形	低	丰富	高	低	低
3	S3	5.1	类圆形	低	丰富	高	稍高	等
4	S5	3.2	类圆形	混合	丰富	高	等	低
5	S3	3.7	不规则形	低	较丰富	高	等	稍低
6	S5.8	6.5	不规则形	混合	丰富	高	稍高	稍高

编号	肿瘤位置	肿瘤直径(cm)	普通超声			超声造影增强程度
编号	肿瘤位置	肿瘤直径(cm)	形态	回声	血供	动脉期	静脉期	延迟期
1	S8	3.1	不规则形	混合	稀少	高	低	低
2	S4	4.5	类圆形	低	丰富	高	低	低
3	S3	5.1	类圆形	低	丰富	高	稍高	等
4	S5	3.2	类圆形	混合	丰富	高	等	低
5	S3	3.7	不规则形	低	较丰富	高	等	稍低
6	S5.8	6.5	不规则形	混合	丰富	高	稍高	稍高

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