尽管多次活检和硬化治疗均为阴性，但原发性肝血管肉瘤仍被误诊为血管瘤：一个诊断陷阱
Primary hepatic angiosarcoma misdiagnosed as hemangioma despite repeated negative biopsies and sclerotherapy: A diagnostic pitfall.
摘要(中文译文)
原发性肝血管肉瘤是一种极为罕见的血管恶性肿瘤，其影像学和组织病理学表现高度多变，有时可类似良性血管瘤。我们描述了一位62岁女性患者，表现为重度贫血和严重血小板减少症以及多灶性肝脏病变，多次空心针活检均被解释为血管瘤。她接受了1次硬化治疗。随着病变在短期内迅速增大并出现不典型的MRI特征，重复活检结合免疫组织化学检查确立了肝血管肉瘤的诊断。她的病程并发急性肾损伤，需要血液透析；随后她在相隔1天内发生2次心脏骤停，最终虽经复苏仍死亡。本病例强调，当推测为血管瘤的病变出现进行性增大、不典型强化模式或与临床行为不一致时，有必要重新审视诊断。
Abstract
Primary hepatic angiosarcoma is a very rare vascular malignancy with highly variable imaging and pathologic appearances, occasionally resembling a benign hemangioma. We describe a 62-year-old woman who presented with profound anemia and severe thrombocytopenia and multifocal hepatic lesions repeatedly interpreted as hemangioma on core needle biopsies. She underwent 1 sessions of sclerotherapy. With rapid interval enlargement and atypical MRI features, a repeat biopsy established the diagnosis of hepatic angiosarcoma, supported by immunohistochemistry. Her course was complicated by acute kidney injury requiring hemodialysis; she subsequently suffered 2 cardiac arrests 1 day apart and finally died despite resuscitation. This case underscores the need to revisit the diagnosis when a presumed hemangioma shows progressive growth, atypical enhancement patterns, or discordant clinical behavior.
如何引用
AMA
Faeze Salahshour, Masoomeh Safaei, Ahmad Rahimian, Mahdi Hazratgholi. Primary hepatic angiosarcoma misdiagnosed as hemangioma despite repeated negative biopsies and sclerotherapy: A diagnostic pitfall.. Radiology case reports. 2026; doi:10.1016/j.radcr.2026.05.047.
APA
Faeze Salahshour, Masoomeh Safaei, Ahmad Rahimian, Mahdi Hazratgholi (2026). Primary hepatic angiosarcoma misdiagnosed as hemangioma despite repeated negative biopsies and sclerotherapy: A diagnostic pitfall.. Radiology case reports. https://doi.org/10.1016/j.radcr.2026.05.047
GB/T 7714
Faeze Salahshour, Masoomeh Safaei, Ahmad Rahimian, Mahdi Hazratgholi. Primary hepatic angiosarcoma misdiagnosed as hemangioma despite repeated negative biopsies and sclerotherapy: A diagnostic pitfall.[J]. Radiology case reports, 2026 doi:10.1016/j.radcr.2026.05.047.
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