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1 病例 患者,男,51岁。就诊时上腹部不适2个月,低热,消瘦,轻度贫血。查体左上腹部巨大肿物,未扪及边界,无明显压痛。B超见左上腹部实性肿物,内部回声均匀,中心部见少许点状无回声区,超声波诊断为左上腹实质占位性病变,性质待定。磁共振检查见左上腹部一巨大肿物大小20.3cm×18.4cm×13.0cm,呈长T1,长T2信号,T1加权中心信号偏高,T2加权中心信号较低,增强扫描肿物周边呈“花边样”强化,边界清晰,印象诊断为左上腹纤维组织细胞瘤。2 病理检查 肿物包膜完整,切面为淡黄色,有纤维化和出血区,质地较软,富有光泽。镜下见瘤组织中瘤细胞疏密不均,多为短梭形或梭形,胞浆嗜酸,核浓染,偶见脂母细胞,局部区可见粘
1 case of patient, male, 51 years old. Upper abdominal discomfort at the time of treatment was 2 months, low fever, weight loss, mild anemia. Examine the massive mass in the left upper abdomen, without palpable borders, without apparent tenderness. B ultrasound see solid masses in the left upper abdomen, the internal echo is even, the center part sees a little punctate echo-free zone, ultrasonic diagnosis is the left upper quadrant parenchymal lesion, and the nature is to be determined. Magnetic resonance examination showed a large tumor size of 20.3cm × 18.4cm × 13.0cm in the left upper abdomen, long T1, long T2 signal, T1 weighted center signal is high, T2 weighted center signal is low, enhanced scan around the tumor was “lace The ”like" enhancement, the boundary is clear, and the impression is diagnosed as a left upper abdominal fibrous histiocytoma. 2 pathological examination The tumor capsule is complete, the cut surface is pale yellow, fibrosis and hemorrhage area, texture is soft, shiny. Microscopically, the tumor cells in the tumor tissue were unevenly dense, mostly short shuttle or fusiform, cytoplasmic eosinophilic, nuclear densely stained, and occasionally lipid masterblasts, local areas were seen viscous