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肝脏血管肉瘤最近已经引起广泛重视,因为它与氯乙烯,氧化钍胶体(Thorotrast)以及砷等致癌物质有关。本文作者报告的一例,说明~(67)Ga-枸橼酸盐能被内皮起源的肝脏肿瘤、肝血管肉瘤所摄取。病例报告:患者男性,86岁,白种人。右侧胸痛,咳嗽,气短巳18个月。体格检查,除右上腹触痛,右下肺呼吸音减低外无其他阳性体征。实验室检查:AKP增高,AFP及癌胚抗原在正常范围内。胸部X线检查发现右侧胸腔有渗出物,但渗出液中未发现癌细胞。超声波检查,右肝叶呈现不同质的回音,提示为肿瘤或浸润过程。X线CT提示该区域有肿瘤或占位性病变。~(99m)Tc-硫化胶体闪烁图发现右肝叶的侧位有界限明显的缺损区。~(67)Ga-枸橼酸盐闪烁图显示右肝叶侧位有2个界限明显的摄取增高的病灶与硫化胶体闪烁图中摄取减低区相符合,但略小些。这些资料提示很可能是一个恶性占位性病变。最后,经肝穿刺组织活检证实为肝脏血管肉瘤。软组织肉瘤与~(67)Ga-枸橼酸盐有很高的亲和力,这是一种已被肯定的事实。已经证实平滑肌肉瘤,横纹肌肉瘤、脂肪肉瘤、ewing’s肉瘤等与~(67)Ga
Hepatic angiosarcoma has recently attracted widespread attention because of its involvement with carcinogens such as vinyl chloride, thorotrast (Thorotrast) and arsenic. An example reported by the authors of this article shows that ~(67)Ga-citrates can be taken up by liver-derived tumors and hepatic angiosarcoma. Case report: The patient was male, 86 years old, Caucasian. Right chest pain, cough, shortness of breath, 18 months. Physical examination, in addition to the right upper quadrant tenderness, lower right lung hypotension and no other positive signs. Laboratory tests: AKP increased, AFP and carcinoembryonic antigen within the normal range. Chest X-ray findings revealed exudates in the right thoracic cavity but no cancerous cells were found in the exudate. In the ultrasound examination, the right liver showed an echo of different qualities, suggesting a tumor or infiltration process. X-ray CT showed tumor or space-occupying lesions in this area. A ~(99m)Tc-vulcanized colloid scintigraphy revealed that the right hepatic lobe had a definite defect in the lateral position. The ~(67)Ga-citrate scintigraphy showed that the two lesions with markedly increased uptake in the lateral position of the right hepatic lobe coincided with, but were slightly smaller than, the uptake-reduced regions in the vulcanized colloid scintigraphy. These data suggest that it is likely to be a malignant space-occupying lesion. Finally, liver biopsy confirmed hepatic angiosarcoma. Soft tissue sarcoma has high affinity with ~(67)Ga-antimonate, which is a fact that has been affirmed. Has been confirmed leiomyosarcoma, rhabdomyosarcoma, liposarcoma, ewing’s sarcoma and ~(67)Ga