medvisМедицинская визуализацияMedical Visualization1607-07632408-9516RDS-Media Ltd.10.24835/1607-0763-2020-4-42-50medvis-969Research ArticleБРЮШНАЯ ПОЛОСТЬABDOMENЭпителиоидная гемангиоэндотелиома печени. Анализ литературы и собственных наблюденийDiagnosis of epithelioid hemangioendothelioma of the liver. Lecture and analysis of own caseshttps://orcid.org/0000-0003-1742-7783РозенгаузЕ. В.RozengauzE. V.

Розенгауз Евгений Владимирович – доктор мед. наук, главный научный сотрудник отдела лучевой диагностики; профессор кафедры лучевой диагностики и лучевой терапии

197758 Санкт-Петербург, пос. Песочный, ул. Ленинградская, д. 70, Российская Федерация

191015 Санкт-Петербург, ул. Кирочная, д. 41, Российская Федерация

Evgeny V. Rozengauz – Doct. of Sci. (Med.), Chief Researcher of the Department of radiology

70, Leningradskaya str., Pesochny, St. Petersburg, 197758, Russian Federation

41, Kirochnaya str., 191015, St. Petersburg, Russian Federation

https://orcid.org/0000-0002-2195-2401ДолбовА. Л.DolbovA. L.

Долбов Артем Леонидович – врач-рентгенолог, младший научный сотрудник отделения радиоизотопной позитронной эмиссионной томографии

197758 Санкт-Петербург, пос. Песочный, ул. Ленинградская, д. 70, Российская Федерация

Тел.: +7-911-290-06-19

Artyom L. Dolbov – Radiologist of the Department of Radioisotope Positron Emission Tomography

70, Leningradskaya str., Pesochny, St. Petersburg, 197758, Russian Federation

Art.dolbov@yandex.ruhttps://orcid.org/0000-0002-1913-9390КарахановаА. Г.KarakhanovaA. G.

Караханова Анна Геннадиевна – врач-рентгенолог

197758 Санкт-Петербург, пос. Песочный, ул. Ленинградская, д. 68, Российская Федерация

Anna G. Karakhanova – Radiologist of the Department of X-ray Computed Tomography

68, Leningradskaya str., Pesochny, St. Petersburg, 197758, Russian Federation

ФГБУ “Российский научный центр радиологии и хирургических технологий имени академика А.М. Гранова” Минздрава России; ФГБОУ ВО “Северо-Западный государственный медицинский университет имени И.И. Мечникова” Минздрава РоссииРоссияA.M. Granov Russian Scientific Center of Radiology and Surgical Technologies; I.I. Mechnikov North Western State Medical UniversityRussian FederationФГБУ “Российский научный центр радиологии и хирургических технологий имени академика А.М. Гранова” Минздрава РоссииРоссияA.M. Granov Russian Scientific Center of Radiology and Surgical TechnologiesRussian FederationФГБУ “ Национальный медицинский исследовательский центр онкологии имени Н.Н. Петрова” Минздрава РоссииРоссияN.N. Petrov National Medical Research Center of OncologyRussian Federation2020101220202444250Copyright © Розенгауз Е.В., Долбов А.Л., Караханова А.Г., 20202020Розенгауз Е.В., Долбов А.Л., Караханова А.Г.Rozengauz E.V., Dolbov A.L., Karakhanova A.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://medvis.rdsmedia.ru/jour/article/view/969

Эпителиоидная гемангиоэндотелиома печени (ЭГЭП) – редкое (1 случай на 1 000 000 человек) первичное новообразование из группы мезенхимальных опухолей. ЭГЭП является наиболее агрессивным представителем семейства гемангиоэндотелиом по метастатическому потенциалу и частоте рецидивов, и в этом отношении чаще близка к ангиосаркоме.

Цель исследования

Цель исследования: обобщение собственного опыта в сопоставлении с данными литературы и описание ранее не исследованного симптома этого заболевания.

Материал и методы

Материал и методы. Нами было изучено 5 случаев ЭГЭП, подтвержденных гистологическим исследованием. Всем пациентам была выполнена компьютерная томография с болюсным контрастированием по стандартной методике.

Результаты

Результаты. При анализе полученных изображений выявлялись симптомы, характерные для данной патологии, такие как локальное втяжение контура печени, специфический паттерн контрастирования – “леденец на палочке”. Нами был выявлен еще один новый симптом – “четок”, который имелся у 4 из 5 пациентов. У 3 из 5 пациентов данный симптом позволил уверенно определить природу заболевания до гистологического исследования.

Заключение

Заключение. ЭГЭП – редкое заболевание, в силу своей редкости и сходства с другими очаговыми поражениями печени вызывающее диагностические затруднения. В лучевой диагностике ЭГЭП целесообразно ориентироваться на достаточно специфичные симптомы: втяжение контура, “леденец на палочке” и “четки”.

Epithelioid hemangioendothelioma of the liver (EHEL) is a rare (1 case per 1 000,000 people) primary malignant neoplasm from the group of mesenchymal tumors. EHEL is the most aggressive representative of the hemangioendothelioma range with metastatic response and relapse rate, and therein is close to angiosarcoma.

The purpose of this publication is to summarize our own experience in comparison with published data and to describe a disease symptom that was not investigated before.

Materials and methods

Materials and methods. We studied five cases of epithelioid hemangioendothelioma of the liver, confirmed by histological examination. All patients underwent standard computer tomography with bolus contrast agent.

Results

Results. The analysis of the images revealed typical for this pathology symptoms such as local retraction of the liver contour, a specific contrast pattern – “the lollipop sign”. We have revealed a new symptom: “the beading sign”, which was detected in four of five cases. In three of five cases, this symptom allowed us to determine the nature of the disease before histological examination.

Conclusion

Conclusion. EHEL is a difficult disease to diagnose due to its rare frequency and similarity to other focal liver lesions. In aspect of radiology, it is advisable to focus on specific symptoms of this pathology: retraction of the contour, “lollipop-sign” and “beading-sign”.

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The authors declare that there are no conflicts of interest present.