1.CT and pathological features of primary hepatic angiosarcoma
Journal of Clinical Hepatology 2014;30(8):779-781
Objective To present the computed tomography (CT)findings and associated pathological features of eight cases of primary he-patic angiosarcoma (PHA).Methods All cases were confirmed by pathology.After a CT scan of the upper abdomen,all cases of PHA un-derwent enhanced scans in the arterial phase,portal venous phase,and delayed phase to observe the CT manifestations.The surgical speci-mens were subjected to conventional hematoxylin-eosin staining and immunohistochemistry and observed under a microscope.Results Of all patients,5 cases were massive type,2 cases were mixed type,and 1 case was multiple nodule type.CT scans revealed inhomogeneous low-density lesions,with necrosis of even lower density in the central part.In 4 cases of massive type,scattered high-density small pieces were observed in low-density areas;in one case of mixed type,high-density nodules were observed on the edge of mass.There were 7 ca-ses of peripheral nodular irregular enhancement in the arterial phase,including 1 case with flocculent central enhancement and another with no enhancement.Lesions remained enhanced in the portal venous and delayed phases,but 1 case had no enhancement.Five in 9 lesions had sharp edges in the arterial and portal venous phases,with“sharpen rim perpendicular to pleura”signs at the boundaries with the surrounding normal liver tissue.The outer edges of 7 lesions were found to have “pseudocapsules”in the portal venous phase.Conclusion CT scans showed a large hypodense lesion with irregular necrotic areas or scattered hemorrhage in PHA patients,whist enhanced scans showed a pro-gressive filling and necrotic area in the central part.There could be“sharpen rim perpendicular to pleura”and“pseudocapsule”signs at the edge.It might be helpful to improve the diagnosis through the above characteristic features.