肝脏子宫内膜异位症1例
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摘要
肝脏子宫内膜异位症是一种以肝内存在异位的子宫内膜为特征的罕见疾病,常表现为含有或不含固体成分的囊性肿块。因缺乏典型症状且影像学诊断困难易被误诊,而组织学检查仍是诊断的金标准。现报告1例泰州市人民医院收治的患者,经彩色多普勒超声检查发现肝脏占位性病变,术前拟诊断为肝囊肿,术后病理证实为肝脏子宫内膜异位症。
Hepatic endometriosis is one of the rarest disorders characterised by the presence of ectopic endometrium in the liver. It is often described as cystic mass with or without solid component. Most cases of hepatic endonmtriosis were misdiagnosed due to the lack of typical symptoms, and histopathologic evaluation remains the golden standard for diagnosis. One patient with space-occupying lesions in the liver diagnosed by color Doppler uhrasonography was admitted to Taizhou People's Hospital. The patient was preliminarily diagnosed as hepatic cyst and then received operation. The result of postoperative pathological examination confirmed hepatic endometriosis.
Hepatic endometriosis is one of the rarest disorders characterised by the presence of ectopic endometrium in the liver. It is often described as cystic mass with or without solid component. Most cases of hepatic endonmtriosis were misdiagnosed due to the lack of typical symptoms, and histopathologic evaluation remains the golden standard for diagnosis. One patient with space-occupying lesions in the liver diagnosed by color Doppler uhrasonography was admitted to Taizhou People's Hospital. The patient was preliminarily diagnosed as hepatic cyst and then received operation. The result of postoperative pathological examination confirmed hepatic endometriosis.
引文
[1]夏文焱,张丹凤,吴英杰.E-钙粘蛋白在子宫内膜异位症中的研究进展[J].实用妇科内分泌杂志,2017,4(34):194.
[2]孙兆发,唐小鹤.子宫内膜食管异位致上消化道出血1例[J].中国误诊学杂志,2006,6(7):1406-1407.
[3]崔翔宇,马虹飞,董绍安,等.肺子宫内膜异位症一例报告及文献复习[J/CD].中华肺部疾病杂志(电子版),2017,10(6):757-758.
[4]刘磊,王学斌,王桂阁,等.胸腔子宫内膜异位症临床特点及诊疗进展[J/CD].中华肺部疾病杂志(电子版),2016,9(6):663-665.
[5]Plodeck V,Sommer U,Baretton GB,et al.A rare case of pancreatic endometriosis in a postmenopausal woman and review of the literature[J].Acta Radiol Open,2016,5(9):2058460116669385.
[6]汪玉良,孙正义,马璐琪.脊髓子宫内膜异位症伴先天性硬脊膜膨出1例报告[J].中国脊柱脊髓杂志,2000,10(4):252-253.
[7]冯锦霞,夏忠胜,钟娃,等.肠道子宫内膜异位症3例报告并文献复习[J].中国实用内科杂志,2018,38(7):670-673.
[8]胡荣胜,马程.无临床症状的肾脏子宫内膜异位症CT误诊一例并文献复习[J].临床放射学杂志,2015,34(8):1340-1341.
[9]张胜民,南永浩,曲立成,等.输尿管子宫内膜异位症1例及文献复习[J].中国实验诊断学,2018,22(3):486-487.
[10]罗勇,赵建华,王晨宇.10例膀胱子宫内膜异位症的临床诊疗分析[J].国际泌尿系统杂志,2017,37(6):887-889.
[11]Haas D,Chvatal R,Reichert B,et al.Endometriosis:a premenopausal disease Age pattern in 42,079 patients with endometriosis[J].ArchGynecol Obstet,2012,286(3):667-670.
[12]李佳雯.干细胞与子宫内膜异位症发病机制的研究进展[J].国际妇产科学杂志,2018,45(1):106-110.
[13]凌丽,熊正爱.子宫内膜异位症免疫机制研究进展[J].国际妇产科学杂志,2015,42(1):33-37.
[14]张光亮,文维群,李娟.慢性乙型肝炎合并子宫内膜异位症患者Th1/Th2细胞应答[J].中国医师杂志,2013,15(2):206-208.
[15]官亮,龚辉,邱梦标.慢性乙型肝炎患者免疫细胞功能分析与恩替卡韦治疗效果研究[J].中华医院感染学杂志,2016,26(15):3373-3375.
[16]Goldsmith PJ,Ahmad N,Dasgupta D,et al.Case hepatic endometriosis:a continuing diagnostic dilemma[J].H P BSurg,2009,2009:407206.
[17]Keramidaris D,Gourgiotis S,Koutela A,et al.Rare case of hepatic endometriosis as an incidental finding:difficult diagnosis of a diagnostic dilemma[J].Ann Hepatol,2018,17(5):884-887.
[18]张荣魁,王继萍,迟长亮,等.肝内子宫内膜异位囊肿1例[J].中国医学影像技术,2015,31(6):970.
[19]李嵩,陈永标,江艺.肝脏子宫内膜异位症误诊为肝包虫病的诊断与治疗[J].中华消化外科杂志,2014,13(5):395-397.
[20]杨兴海,王成林,江勇.肝脏子宫内膜异位症一例[J].中华普通外科杂志,2017,32(11):972.
[21]李端阳.肝子宫内膜异位性囊肿(文献综述)[J].国外医学外科学分册,1998(5):290.
[22]郭路路,王伟,郝敏.VEGF-A在子宫内膜异位症中的研究进展[J].国际妇产科学杂志,2018,45(1):111-114.
[23]张若楠,姜雯,刘爱菊,等.白细胞介素-10在子宫内膜异位症的研究进展[J].疾病监测与控制,2017,11(9):710-712.
[24]汤礼宾,章志福,麦丽兰.血清CA125、VEGF、MCP-1在子宫内膜异位症诊断中的应用价值[J].临床和实验医学杂志,2018,17(10):1085-1088.
[25]许曼红,谢秋娴,杨纯.子宫内膜异位症患者血清及腹腔液6-异前列腺素F1α的表达及意义[J].临床医学工程,2012,19(6):889-890.
[26]李妞妞,郭广玲,王铁延.子宫内膜异位症与免疫炎症、氧化应激及血管生成的相关性研究[J].标记免疫分析与临床,2018,25(4):468-471.
[2]孙兆发,唐小鹤.子宫内膜食管异位致上消化道出血1例[J].中国误诊学杂志,2006,6(7):1406-1407.
[3]崔翔宇,马虹飞,董绍安,等.肺子宫内膜异位症一例报告及文献复习[J/CD].中华肺部疾病杂志(电子版),2017,10(6):757-758.
[4]刘磊,王学斌,王桂阁,等.胸腔子宫内膜异位症临床特点及诊疗进展[J/CD].中华肺部疾病杂志(电子版),2016,9(6):663-665.
[5]Plodeck V,Sommer U,Baretton GB,et al.A rare case of pancreatic endometriosis in a postmenopausal woman and review of the literature[J].Acta Radiol Open,2016,5(9):2058460116669385.
[6]汪玉良,孙正义,马璐琪.脊髓子宫内膜异位症伴先天性硬脊膜膨出1例报告[J].中国脊柱脊髓杂志,2000,10(4):252-253.
[7]冯锦霞,夏忠胜,钟娃,等.肠道子宫内膜异位症3例报告并文献复习[J].中国实用内科杂志,2018,38(7):670-673.
[8]胡荣胜,马程.无临床症状的肾脏子宫内膜异位症CT误诊一例并文献复习[J].临床放射学杂志,2015,34(8):1340-1341.
[9]张胜民,南永浩,曲立成,等.输尿管子宫内膜异位症1例及文献复习[J].中国实验诊断学,2018,22(3):486-487.
[10]罗勇,赵建华,王晨宇.10例膀胱子宫内膜异位症的临床诊疗分析[J].国际泌尿系统杂志,2017,37(6):887-889.
[11]Haas D,Chvatal R,Reichert B,et al.Endometriosis:a premenopausal disease Age pattern in 42,079 patients with endometriosis[J].ArchGynecol Obstet,2012,286(3):667-670.
[12]李佳雯.干细胞与子宫内膜异位症发病机制的研究进展[J].国际妇产科学杂志,2018,45(1):106-110.
[13]凌丽,熊正爱.子宫内膜异位症免疫机制研究进展[J].国际妇产科学杂志,2015,42(1):33-37.
[14]张光亮,文维群,李娟.慢性乙型肝炎合并子宫内膜异位症患者Th1/Th2细胞应答[J].中国医师杂志,2013,15(2):206-208.
[15]官亮,龚辉,邱梦标.慢性乙型肝炎患者免疫细胞功能分析与恩替卡韦治疗效果研究[J].中华医院感染学杂志,2016,26(15):3373-3375.
[16]Goldsmith PJ,Ahmad N,Dasgupta D,et al.Case hepatic endometriosis:a continuing diagnostic dilemma[J].H P BSurg,2009,2009:407206.
[17]Keramidaris D,Gourgiotis S,Koutela A,et al.Rare case of hepatic endometriosis as an incidental finding:difficult diagnosis of a diagnostic dilemma[J].Ann Hepatol,2018,17(5):884-887.
[18]张荣魁,王继萍,迟长亮,等.肝内子宫内膜异位囊肿1例[J].中国医学影像技术,2015,31(6):970.
[19]李嵩,陈永标,江艺.肝脏子宫内膜异位症误诊为肝包虫病的诊断与治疗[J].中华消化外科杂志,2014,13(5):395-397.
[20]杨兴海,王成林,江勇.肝脏子宫内膜异位症一例[J].中华普通外科杂志,2017,32(11):972.
[21]李端阳.肝子宫内膜异位性囊肿(文献综述)[J].国外医学外科学分册,1998(5):290.
[22]郭路路,王伟,郝敏.VEGF-A在子宫内膜异位症中的研究进展[J].国际妇产科学杂志,2018,45(1):111-114.
[23]张若楠,姜雯,刘爱菊,等.白细胞介素-10在子宫内膜异位症的研究进展[J].疾病监测与控制,2017,11(9):710-712.
[24]汤礼宾,章志福,麦丽兰.血清CA125、VEGF、MCP-1在子宫内膜异位症诊断中的应用价值[J].临床和实验医学杂志,2018,17(10):1085-1088.
[25]许曼红,谢秋娴,杨纯.子宫内膜异位症患者血清及腹腔液6-异前列腺素F1α的表达及意义[J].临床医学工程,2012,19(6):889-890.
[26]李妞妞,郭广玲,王铁延.子宫内膜异位症与免疫炎症、氧化应激及血管生成的相关性研究[J].标记免疫分析与临床,2018,25(4):468-471.