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原发性肝癌以肝内囊性病为特点者(下称“囊性肝癌”)误诊误治率高.本文分析了自1988年11月至1991年10月所收治108例原发性肝癌中的4例囊性肝癌的诊治体会.1 临床资料 4例中男3例,女1例,年龄35岁~68岁;病程3天~l月余;均有右上腹不适或疼痛;伴畏寒发烧1例,扪及右上腹肿物2例,腹水或黄疸各1例;AFP>400ng/ml例;BUS示肝占位1例;3例术前CT检查均示肝内囊性占位,1例术后CT检查示肝多发结节.2 诊断 术前诊为肝癌1例,肝囊腺瘤或癌难定1例,术前乃至术中误诊为“肝脓肿”和“先天性肝内胆管扩张”?各1例.病理确诊为“原发性肝细胞癌”2例,2例依临床、AFP、BUS 、CT综合诊断为囊性肝癌.
Patients with primary liver cancer characterized by intrahepatic cystic disease (hereinafter referred to as “cystic liver cancer”) have a high rate of misdiagnosis and misdiagnosis. This article analyzed 108 cases of primary liver cancer treated from November 1988 to October 1991. 4 cases of cystic liver cancer diagnosis and treatment experience. 1 clinical data in 4 cases of 3 males and 1 female, aged 35 years to 68 years; duration of 3 days ~ l months; have right upper quadrant discomfort or pain; with chills fever 1 case, 2 cases of hernia and right upper abdominal mass, 1 case of ascites or jaundice; AFP> 400ng/ml cases; BUS showed hepatic mass occupying 1 case; 3 cases preoperative CT examination showed intrahepatic cystic mass, 1 CT scans showed multiple liver nodules.2 Preoperative diagnosis of liver cancer in 1 case, hepatic cystadenoma or cancer in 1 case, misdiagnosed as “hepatic abscess” and “congenital intrahepatic bile duct ”Expansion“ in 1 case. Pathologically diagnosed as ”primary hepatocellular carcinoma" in 2 cases, 2 cases according to clinical, AFP, BUS, CT comprehensive diagnosis of cystic liver cancer.