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患者女,74岁。因右上腹间断性疼痛不适1个月余加重1天入院。病程呈慢性起病,无明显诱因,间断隐痛伴腹胀,无放射痛,无发热,无恶心、呕吐。既往体健,无肝炎、肝硬化史,无家族遗传史。体检:腹部柔软,肝脏肋下四横指可触及,右肋缘下压痛,肝区叩击痛,Murphy征阴性,移动性浊音阴性。实验室检查及肿瘤标记物检查阴性。CT平扫:肝右叶椭圆形巨大软组织肿块,大小约为12.6cm×15.2 cm×15.5 cm,边界较清晰,密度不均匀,其内部可见低密度液化坏死区(图1);增强扫描动脉期肿块周围实性
Female patient, 74 years old. Due to the right upper quadrant intermittent pain discomfort 1 month more than 1 day admitted to hospital. The course of disease was chronic onset, no obvious incentive, intermittent pain with abdominal distension, no radiating pain, no fever, no nausea, vomiting. Past physical health, no hepatitis, history of liver cirrhosis, no family history. Physical examination: Abdomen soft, four ribs under the ribs of the liver can be touched, tenderness under the right costal margin, percussion pain in the liver area, Murphy sign negative, shifting dullness negative. Laboratory tests and tumor markers negative. CT scan: the right lobe of the ellipse huge soft tissue mass, the size of about 12.6cm × 15.2cm × 15.5cm, the boundaries are clear, the density is uneven, its internal visible low-density liquefied necrosis area (Figure 1); enhanced scan arterial phase Mass around the solid