病理学讨论Greenfield:在病人住院后第8天和其后不久,共作了几次放射学检查,以找寻胃肠道出血的来源和黄疸的原因。肝血管造影显示,虽然肝动脉仍然闭塞,但通过侧支的血管,肝内再次有一个血管性肿块致密显影。再次出现广泛的动静脉分流(肝动脉至门静脉),而且肿块较上次的检查时已增大两倍。可以认为胃肠道出血的复发是继发于由肿瘤侧枝循环建立产生的门脉动脉化。因为肝动脉仍然闭塞, Pathology Discussion Greenfield: On the 8th day and shortly after the patient’s hospitalization, a total of several radiological examinations were performed to find the source of gastrointestinal bleeding and the cause of jaundice. Hepatic angiography showed that although the hepatic artery was still occluded, there was once again a dense vascular mass in the liver through the collateral vessels. An extensive arteriovenous shunt (hepatic artery to portal vein) reappeared, and the mass was double compared to the previous examination. It can be considered that the recurrence of gastrointestinal bleeding is secondary to the arterialization of the portal vein resulting from the establishment of a collateral circulation of the tumor. Because the hepatic artery is still occluded,