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1 临床资料患者男,49岁.于1996年10月4日在某地体检发现肝右叶占位20天,来我院诊治.患者有乙肝病史.实验室检查:肝功能正常,HBsAg、HBsAb、HBcAb均阳性,AFP7700μg/L.B超检查发现肝区回声呈中粗光点,分布均匀,血管纹理可见,于肝右叶可探及13.0cm×14.1cm异常杂乱回声团块,边界欠清,内回声强弱不均.CT扫描示肿块密度不均,增强扫描后肿瘤上半部分区域完全强化,下半部仅部分强化;提示:肝右叶原发性肝癌合并肝海绵状血管瘤.MRI检查:肝脏上半部为典型血管瘤,表现高信号,下半部为稍高信号.患者于1996年11月25日在全麻下行有半肝切除术,术中见肝右叶Ⅴ、Ⅵ段有6cm×6cm肿物,质硬、表面灰白色、凹凸不平、呈多结节融合状、无明显包膜,在Ⅶ、Ⅷ段见9cm×8cm暗红色肿物,光滑、质软、有压缩感.病理检查:肝脏
1 Clinical data The patient was male, 49 years old. He was diagnosed in a local medical examination on October 4th, 1996. He was diagnosed and treated in our hospital for a period of 20 days. The patient had a history of hepatitis B. Laboratory tests: Normal liver function, HBsAg, HBsAb HBcAb were positive, AFP7700μg/LB ultrasonography showed that the echo in the liver showed a medium thick spot, uniform distribution of blood vessels, visible in the right lobe of the liver and 13.0cm×14.1cm abnormally cluttered echo mass, the boundary was less clear, Echoes were not uniform. CT scans showed uneven mass density. After enhanced scans, the upper half of the tumor was completely intensified, and the lower half was only partially intensified. Tip: Primary right hepatic liver cancer with hepatic cavernous hemangioma. MRI examination : The upper part of the liver is a typical hemangioma with high signal and the lower part is slightly hyperintense. The patient underwent partial hepatectomy under general anesthesia on November 25, 1996. During the operation, the right hepatic lobe V and VI were seen. 6cm x 6cm tumor mass, hard surface, grayish white surface, irregular, multinodular fusion, no obvious capsule, see 9cm x 8cm dark red mass in section VII, VIII, smooth, soft, with a sense of compression . Pathological examination: Liver