Hepatic hemangioma

Introduction to hepatic hemangioma The majority of hemangiomas (cavernoushemangioma) is a common benign tumor of the liver, which can occur at any age, but often occurs in adults, more women, hepatic hemangioma is the most in the liver Common benign tumors can be diagnosed in most cases before surgery, the vast majority of asymptomatic, a small number of patients with large tumors and liver discomfort. basic knowledge The proportion of illness: 0.002% Susceptible people: no special people Mode of infection: non-infectious Complications: hepatic cyst

Hepatic hemangioma etiology

Hepatic hemangioma is the most common benign tumor in the liver, accounting for 84% of benign liver tumors, and is more common in older women. Most of them are cavernous hemangioma, rarely capillary hemangioma and hemangioendothelioma. Multiple pregnancy and oral contraceptives are more common. The lesion can be single or multiple, more common in the posterior segment of the right lobe of the liver.

The pathological change is the tumor connective tissue capsule, which is clearly demarcated from the surrounding liver tissue. It is composed of a blood-filled vascular cyst, with a fibrous space between the cysts, and the cyst wall is lined with flat endothelial cells. Tumors can develop fibrosis, calcification and thrombosis.

The exact cause of the disease is still unclear. There are mainly the following theories:

Congenital dysplasia (25%):

The occurrence of hepatic hemangioma is caused by congenital vascular malformation of the peripheral liver. During the development of the embryo, due to abnormal liver vascular development, the vascular endothelial cells are abnormally proliferated to form hepatic hemangioma.

Hormone stimulation (30%):

Female puberty, pregnancy, oral contraceptives can accelerate the growth of hemangioma, and it is believed that female hormone may be a causative factor of hemangioma.

Other (25%):

Some people think that capillary tissue is deformed after infection, leading to telangiectasia. After local necrosis of liver tissue, the blood vessels dilate to form vacuoles, and the surrounding blood vessels are congested and dilated; the regional blood circulation in the liver is stagnant, causing the blood vessels to form a sponge-like expansion.

Hepatic hemangioma prevention

Although hepatic hemangioma has congenital factors, its growth is caused by acquired factors, so prevention is to avoid factors that cause tumor growth, such as correct treatment of various things, relieve anxiety, nervousness, and avoid emotional trauma. Diet should be less fat and spicy and spicy products, eat more fresh vegetables, do not drink alcohol, usually pay attention to exercise, such as seeing a block in the abdomen, body weight loss, fatigue and fatigue and other symptoms should be checked early, timely treatment.

Hepatic hemangioma complications Complications liver cyst

1. Hepatic hemangioma rupture: can cause acute abdomen or internal bleeding symptoms.

2. Thrombocytopenia and hypofibrinogenemia: A small number of patients often cause this disease due to a disorder of blood coagulation.

3. Liver enlargement: When the hemangioma grows up, it can cause liver enlargement.

4. Liver cysts: About 10% of patients can have liver cysts.

Hepatic hemangioma symptoms Common symptoms Loss of appetite Abdominal discomfort Liver enlargement Abdominal discomfort Digestive coagulopathy Thrombocytopenia Pain

Small lesions are asymptomatic. After physical examination, large lesions can cause upper abdominal discomfort or touch the mass. Giant hemangioma can significantly increase the liver. Clinical manifestations, <4cm are asymptomatic, often physical examination. Accidentally found in abdominal ultrasound; about 40% of people with 4cm or more with abdominal discomfort, hepatomegaly, loss of appetite, indigestion and other symptoms, hepatic hemangioma often contains mechanical thrombosis may cause repeated tumor thrombosis caused by tumor swelling, causing Glisson's package Membrane traction pain, lumps of soft and hard, different degrees of compressible sensation, a few hard nodular sensation, small spontaneous rupture of the mass, normal liver function, a rare syndrome of large hemangioma is consumptive coagulopathy , thrombocytopenia and hypofibrinemia.

Hepatic hemangioma

1. Ultrasound performance:

It shows homogenization in the liver, strong echogenic lesions, most of the boundaries are clear, or strong echoes in the lesion area with irregular hypoechoic, and the lesions can show dilated sinusoids.

2. CT performance:

(1) plain scan: low density area in the liver, clear outline, uniform density or lower density area in the lesion area, representing thrombosis or fiber separation, a small number of calcification can be seen.

(2) Enhanced scanning:

1 The edge of the early lesion was significantly enhanced with nodular or "island-like", and the density was similar to that of the adjacent abdominal aorta, which was significantly higher than the density of the surrounding liver parenchyma and lasted for more than 2 minutes.

2 As time goes by, the enhancement range is pushed closer to the center of the lesion, while the low-density area of the lesion is relatively smaller.

3 time-lapse scanning lesions are of equal density or slightly higher density (no change in the lesions during the flat scan).

Enhanced scanning is an important method for diagnosing hepatic cavernous hemangioma. It has a characteristic performance, and the diagnostic accuracy can be more than 90%. The typical typical appearance is in the early stage of arteries, that is, 30 to 60 seconds after injection, so the correct inspection technique is emphasized. , that is, rapid, lumpy injection of contrast agent, rapid scanning, timely delay scanning, otherwise, because of the absence of characteristic performance, it is easy to cause misdiagnosis or missed diagnosis.

3. Isotope: 99mTC hepatic blood pool scan and hepatic angiography are helpful for the diagnosis of hepatic hemangioma, showing no tumor staining, sharp and sharp edges, and longer angioma development time.

4. MRI: The T1 image showed low signal intensity and prolonged T2 relaxation time, which was characterized by high signal intensity tissue.

Diagnosis and diagnosis of hepatic hemangioma

Can be diagnosed based on clinical symptoms and laboratory tests.

Differential diagnosis

1. Hepatocellular carcinoma: generally has a history of hepatitis and cirrhosis, AFP can be positive, and intravenous enhanced scanning can help identify.

2. Liver metastases: Some enhanced intrahepatic metastases can show marginal enhancement, similar to the early manifestations of hemangiomas, but delayed scanning can be identified by low density.

3. Liver abscess: the general boundary of the lesion is unclear, blurred, low-density halo around the abscess, typical lesions around the strengthening, the presence of gas in the lesion, combined with clinical manifestations.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.