肝原発Myelolipomaの1例 画像診断所見を中心に
極めて稀な肝原発.Myelolipomaの1例を報告する.症例は73歳女性,腹部不定愁訴にて近医受診しUSにて肝後上区にhyperechogenic massを発見される.CTにてenhanceされる脂肪性腫瘍と判明し,血管造影ではhypervascularityを呈した.MRIにて病変部はT1強調像でhypointensity, T2強調像でhyperintensityを呈した.これら画像診断から悪性を否定しえず,針生検を施行するも検体不足の為に診断に至らず,肝右葉切除術が施行された.術後病理組織学的にmyelolipomaと診断された.肝原発myelolipomaは現在まで本症例を含め6例...
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| Published in | 肝臓 Vol. 30; no. 1; pp. 88 - 92 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本肝臓学会
1989
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0451-4203 1881-3593 |
| DOI | 10.2957/kanzo.30.88 |
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| Abstract | 極めて稀な肝原発.Myelolipomaの1例を報告する.症例は73歳女性,腹部不定愁訴にて近医受診しUSにて肝後上区にhyperechogenic massを発見される.CTにてenhanceされる脂肪性腫瘍と判明し,血管造影ではhypervascularityを呈した.MRIにて病変部はT1強調像でhypointensity, T2強調像でhyperintensityを呈した.これら画像診断から悪性を否定しえず,針生検を施行するも検体不足の為に診断に至らず,肝右葉切除術が施行された.術後病理組織学的にmyelolipomaと診断された.肝原発myelolipomaは現在まで本症例を含め6例のみが報告されている.術前のUS, CT,血管造影等から他の脂肪成分に富む肝腫瘍との鑑別は困難とされている.しかし本症例に始めて施行されたMRIにおけるT1強調像は報告されている脂肪変性を伴う肝細胞癌のT1強調像と明らかに異なり,両者を鑑別する上で有用な所見と考える. |
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| AbstractList | 極めて稀な肝原発.Myelolipomaの1例を報告する.症例は73歳女性,腹部不定愁訴にて近医受診しUSにて肝後上区にhyperechogenic massを発見される.CTにてenhanceされる脂肪性腫瘍と判明し,血管造影ではhypervascularityを呈した.MRIにて病変部はT1強調像でhypointensity, T2強調像でhyperintensityを呈した.これら画像診断から悪性を否定しえず,針生検を施行するも検体不足の為に診断に至らず,肝右葉切除術が施行された.術後病理組織学的にmyelolipomaと診断された.肝原発myelolipomaは現在まで本症例を含め6例のみが報告されている.術前のUS, CT,血管造影等から他の脂肪成分に富む肝腫瘍との鑑別は困難とされている.しかし本症例に始めて施行されたMRIにおけるT1強調像は報告されている脂肪変性を伴う肝細胞癌のT1強調像と明らかに異なり,両者を鑑別する上で有用な所見と考える. |
| Author | 内野, 純一 森田, 穣 藤田, 美悧 広村, 忠雄 佐々木, 憲一 |
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| References | 18) Pounder DJ: Hepatic pseudolipoma. pathology 15: 83-84, 1983 11) Chen KTK, Felix EL, Flam MS: Extraadrenal myelolipoma. Am J Clin Pathol 78: 386-389, 1982 12) Plaut A: Myelolipoma in the adrenal cortex (myeloadipose structures). Am J Pathol 34: 487-515, 1958 17) Kurdziel JC, Stines J, Parache RM, et al: Adenolipoma of the liver. Euro J Radiol 4: 45-46, 1984 14) Itai Y, Ohtomo K, Kokubo T, et al: CT and MR imaging of fatty tumors of the liver. J Comput Assist Tomogr 11: 253-257, 1987 16) Mathieu D, Bruneton JN, Drouillard J, et al: Hepatic adenoma and focal nodular hyperplasia: Dynamic CT study. Radiology 160: 53-58, 1986 1) Grosdidier J, Boissel P, Macinot C, et al: Myelolipome hepatique: A propos d'une observation, Nouv Pree Med, 2, 1973, p 1777-1779 9) Kim K, Koo BC, Davis JT, et al: Primary myelolipoma of mediastinum. CT 8: 119-123, 1987 3) Rubin E, Russinovich NAE, Luna RF, et al: Myelolipoma of the liver. Cancer 54: 2043-2046, 1984 20) Ebara M, Ohto M, Watanabe Y, et al: Diagnosis of small hepatocellular carcinoma: Correlation of MR imaging and tumor histologic studies. Radiology 159: 371-377, 1986 2) Ishak KG: Mesenchymal tumor of the liver. In: Edited by Hepatocellular carcinoma. Okuda K, Peter RL, John Wiley & Son, 1976, p 247-307 7) Sutker B, Balthazar EJ, Fazzini E: Presacral myelolipoma: CT findings. J Comput Assist Tomogr 9: 1128-1130, 1985 15) Dooms GC, Fisher MR, Hricak H, et al: Bone marrow imaging: Magnetic resonances studies related to age and sex. Radiology 155: 429-432, 1985 19) Itoh K, Nishimura K, Togashi K, et al: Hepatocellular carcinoma: MR imaging. Radiology 164: 21-25, 1987 8) Beraha D, Block NL, Politano Va: Myelolipoma of the kidney. J Urol 112: 19-20, 1974 5) Rubin HB, Hirose F, Benfield JR: Myelolipoma of the adrenal gland. Am J Surg 130: 354-358, 1975 6) Burrows S, Drake WM, Singley TL: Large retroperitoneal myelolipoma associated with acute myelogenous leukemia. Am J Clin Pathol 52: 733-736, 1969 13) Roberts JL, Fishman EK, Hartman DS, et al: Lipomatous tumor of the liver: Evaluation with CT and US. Radiology 158: 613-617, 1986 10) Behan M, Martin EC, Muecke EC, et al: Myelolipoma of theadrenal: Two cases with ultrasound and CT findings. Am J Roentgenol 129: 993-996, 1977 4) Mali SPM, Gratamas S, Mulder H: Myelolipoma of the liver. Fortschr. Rontgenstr 144: 610-611, 1986 |
| References_xml | – reference: 3) Rubin E, Russinovich NAE, Luna RF, et al: Myelolipoma of the liver. Cancer 54: 2043-2046, 1984 – reference: 16) Mathieu D, Bruneton JN, Drouillard J, et al: Hepatic adenoma and focal nodular hyperplasia: Dynamic CT study. Radiology 160: 53-58, 1986 – reference: 15) Dooms GC, Fisher MR, Hricak H, et al: Bone marrow imaging: Magnetic resonances studies related to age and sex. Radiology 155: 429-432, 1985 – reference: 1) Grosdidier J, Boissel P, Macinot C, et al: Myelolipome hepatique: A propos d'une observation, Nouv Pree Med, 2, 1973, p 1777-1779 – reference: 13) Roberts JL, Fishman EK, Hartman DS, et al: Lipomatous tumor of the liver: Evaluation with CT and US. Radiology 158: 613-617, 1986 – reference: 5) Rubin HB, Hirose F, Benfield JR: Myelolipoma of the adrenal gland. Am J Surg 130: 354-358, 1975 – reference: 14) Itai Y, Ohtomo K, Kokubo T, et al: CT and MR imaging of fatty tumors of the liver. J Comput Assist Tomogr 11: 253-257, 1987 – reference: 20) Ebara M, Ohto M, Watanabe Y, et al: Diagnosis of small hepatocellular carcinoma: Correlation of MR imaging and tumor histologic studies. Radiology 159: 371-377, 1986 – reference: 6) Burrows S, Drake WM, Singley TL: Large retroperitoneal myelolipoma associated with acute myelogenous leukemia. Am J Clin Pathol 52: 733-736, 1969 – reference: 9) Kim K, Koo BC, Davis JT, et al: Primary myelolipoma of mediastinum. CT 8: 119-123, 1987 – reference: 18) Pounder DJ: Hepatic pseudolipoma. pathology 15: 83-84, 1983 – reference: 7) Sutker B, Balthazar EJ, Fazzini E: Presacral myelolipoma: CT findings. J Comput Assist Tomogr 9: 1128-1130, 1985 – reference: 8) Beraha D, Block NL, Politano Va: Myelolipoma of the kidney. J Urol 112: 19-20, 1974 – reference: 4) Mali SPM, Gratamas S, Mulder H: Myelolipoma of the liver. Fortschr. Rontgenstr 144: 610-611, 1986 – reference: 19) Itoh K, Nishimura K, Togashi K, et al: Hepatocellular carcinoma: MR imaging. Radiology 164: 21-25, 1987 – reference: 10) Behan M, Martin EC, Muecke EC, et al: Myelolipoma of theadrenal: Two cases with ultrasound and CT findings. Am J Roentgenol 129: 993-996, 1977 – reference: 17) Kurdziel JC, Stines J, Parache RM, et al: Adenolipoma of the liver. Euro J Radiol 4: 45-46, 1984 – reference: 12) Plaut A: Myelolipoma in the adrenal cortex (myeloadipose structures). Am J Pathol 34: 487-515, 1958 – reference: 11) Chen KTK, Felix EL, Flam MS: Extraadrenal myelolipoma. Am J Clin Pathol 78: 386-389, 1982 – reference: 2) Ishak KG: Mesenchymal tumor of the liver. In: Edited by Hepatocellular carcinoma. Okuda K, Peter RL, John Wiley & Son, 1976, p 247-307 |
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| Snippet | 極めて稀な肝原発.Myelolipomaの1例を報告する.症例は73歳女性,腹部不定愁訴にて近医受診しUSにて肝後上区にhyperechogenic... |
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| Subtitle | 画像診断所見を中心に |
| Title | 肝原発Myelolipomaの1例 |
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