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患男,49岁。以右上腹持续性钝痛3月入院。查体:右上腹压痛,叩击痛,无反跳痛。腹软,肝脾未及。CT示:肝右叶10cm×10cm低密度影,周边为一亮晕,并见一直径2cm小灶。诊断:肝脏占位性病变,考虑肝癌。手术见肝脏右叶膈面有一直径10cm肿物、硬、浸润膈肌。行右半肝切除术。病理检查:切除肝脏右叶,一侧见一10cm×10cm×7cm肿物。切面实性灰白、质中等、边界较清、无包膜。部分区域有出血坏死、质脆,部分区域发亮、鱼肉状。肿物侵及被膜,其周边见一2cm灰白实性卫星结节。周围肝组织未见异常。显微镜下肿物由腺上皮细胞及梭形间叶细胞组成,均有明显异型性。腺细胞大多为椭圆形、较大,胞浆均质嗜伊红色,排列呈腺样。梭形细胞胞浆丰富嗜伊红色,核
Suffering from men, 49 years old. Sustained dull pain in the right upper quadrant was admitted to hospital in March. Physical examination: right upper quadrant tenderness, percussion pain, no rebound tenderness. Soft abdomen, liver and spleen is not. CT showed: the right lobe 10cm × 10cm low-density shadow, surrounded by a bright halo, and see a diameter of 2cm foci. Diagnosis: Liver occupying lesions, consider liver cancer. The operation showed that the right hepatic surface of the liver had a 10 cm diameter tumor, hard, and infiltrated diaphragmatic muscle. Right hepatectomy. Pathological examination: The right lobe of the liver was removed and a 10cm x 10cm x 7cm tumor was seen on one side. The cut surface is solid gray, medium in quality, clear in boundary, and non-enveloped. In some areas, there is hemorrhage and necrosis, crispy, and some areas are shiny and fishy. The tumor invaded the capsule and a 2 cm grey solid satellite nodule was seen around the tumor. There was no abnormality in the surrounding liver tissue. Microscopically, the tumor consists of glandular epithelial cells and spindle-shaped mesenchymal cells, all of which are clearly atypical. The glandular cells are mostly elliptical and large. The cytoplasm is homogenous and eosinophilic. The arrangement is adenoid. Spindle cytoplasm rich in eosinophilic red, nuclear