胃腺癌肝转移伴肠母细胞分化的影像学特征1例。

IF 1.4 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Mariko Irizato, Kiyoyuki Minamiguchi, Yasuko Fujita, Hidekazu Yamaura, Hiroaki Onaya, Ryosuke Taiji, Toshihiro Tanaka, Yoshitaka Inaba
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引用次数: 0

摘要

背景:胃腺癌伴肠母细胞分化(GAED)是产生甲胎蛋白(AFP)的胃癌的常见亚型之一。GAED经常导致静脉侵入和肝转移,后者尤其与预后不良有关。到目前为止,由于与肝细胞癌的影像学相似,产afp的胃癌发生肝转移的证据仅集中在胃肝样腺癌。本病例报告描述了GAED肝转移的特征性诊断影像学表现。病例总结:一名65岁男性,两年前因GAED行幽门胃切除术,发现肝7段有肝肿瘤,伴血清AFP水平升高。动态增强计算机断层扫描显示肿瘤在动脉期表现为外周强化,在延迟期表现为持续的中央强化。钆-乙氧基苄基-二乙烯三胺五乙酸增强磁共振成像显示肿瘤周围化学移位成像信号下降,并伴有动脉增强。此外,在肝胆期观察到肿瘤周围的环状低密度。术后检查证实肿瘤为GAED转移灶。组织病理学检查显示肿瘤严重侵犯肿瘤周围的门静脉和肝静脉,这解释了影像学特征。结论:血管侵犯引起的血流改变的影像学特征可能是诊断GAED肝转移的关键。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Distinctive imaging features of liver metastasis from gastric adenocarcinoma with enteroblastic differentiation: A case report.

Background: Gastric adenocarcinoma with enteroblastic differentiation (GAED) is one of the common subtypes of alpha-foetoprotein (AFP)-producing gastric cancer. GAED frequently results in venous invasion and liver metastasis, the latter being particularly linked to a poor prognosis. So far, the evidence for liver metastases from AFP-producing gastric cancer is only focused on those from gastric hepatoid adenocarcinoma, owing to their imaging similarities with hepatocellular carcinoma. This case report describes the characteristic diagnostic imaging findings of liver metastasis from GAED.

Case summary: A 65-year-old man who had undergone a pyloric gastrectomy for GAED two years ago was found to have a liver tumor in the hepatic segment 7, accompanied by elevated serum AFP levels. Dynamic contrast-enhanced computed tomography revealed the tumor showing peripheral-dominant enhancement in the arterial phase with persistent central enhancement in the delayed phase. Gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid-enhanced magnetic resonance imaging demonstrated a signal drop in the tumor periphery in chemical shift imaging, along with arterial enhancement. Additionally, rim-like hypointensity surrounding the tumor was observed in the hepatobiliary phase. Postresection examination confirmed the tumor to be a metastasis from GAED. Histopathological examination revealed severe invasion of the tumor into the portal vein and hepatic vein surrounding the tumor, which explained the imaging features.

Conclusion: The imaging features of blood flow alternations resulting from vascular invasion may be crucial to diagnosing liver metastases from GAED.

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来源期刊
World journal of radiology
World journal of radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
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