放射影像（五十九）　淋巴上皮瘤樣膽管癌的影像學表現

10.6666/ClinMed.2017.80.1.079

柳建安；廖贊傑；邱怡友

淋巴上皮瘤樣癌(lymphoepithelioma-like carcinoma, LELC) ； 淋巴上皮瘤樣膽管癌(lymphoepithelioma-like cholangiocarcinoma) ； 核磁共振攝影(magnetic resonance imaging) ； 人類疱疹毒第四型(Epstein-Barr virus, EBV) ； 肝細胞癌(hepatocellular carcinoma)

臨床醫學月刊

80卷1期（2017 / 07 / 28）

421 - 425

繁體中文

原發性淋巴上皮瘤樣癌(lymphoepithelioma-like carcinoma, LELC)在肝腫瘤中極為少見。在過去的文獻僅有少數淋巴上皮瘤樣膽管癌(lymphoepithelioma -like cholangiocarcinoma)的病例被報導過，但很少描述其影像學表現。此腫瘤多發生於中老年人。而在電腦斷層影像中腫瘤實質大部分會呈現低密度伴隨著低血管或高血管性，有時不易與肝細胞癌區分。在這裡我們提供一個病例報告並同時有超聲，電腦斷層和核磁共振的影像學資料及病理學檢查。我們建議淋巴上皮瘤樣膽管癌應該列為非典型的肝細胞癌影像的鑑別診斷之一。

1. Adachi, S,Morimoto, O,Kobayashi, T(2008).Lymphoepithelioma-like cholangiocarcinoma not associated with EBV.Pathol Int,58,69-74.
2. Bruix, J,Sherman, M(2011).Management of hepatocellular carcinoma: an update.Hepatol,53,1020-1022.
3. Chan, AW,Tong, JH,Sung, MY(2014).Epstein-Barr virus-associated lymphoepithelioma-like cholangiocarcinoma: a rare variant of intrahepatic cholangiocarcinoma with favourable outcome.Histopathology,65,674-683.
4. Chen, TC,Ng, KF,Kuo, T(2001).Intrahepatic cholangiocarcinoma with lymphoepithelioma-like component.Mod Pathol,14,527-532.
5. Choi, BI,Lee, JH,Han, MC(1989).Hilar cholangiocarcinoma: comparative study with sonography and CT.Radiol,172,689-692.
6. Fowler, KJ,Sheybani, A,Parker, RA(2013).Combined hepatocellular and cholangiocarcinoma (biphenotypic) tumors: imaging features and diagnostic accuracy of contrast-enhanced CT and MRI.AJR Am J Roentgenol,201,332-339.
7. Han, JK,Choi, BI,Kim, AY(2002).Cholangiocarcinoma: pictorial essay of CT and cholangiographic findings.Radiographics,2,173-187.
8. Henderson-Jackson, E,Nasir, NA,Hakam, A(2010).Primary mixed lymphoepithelioma-like carcinoma and intra-hepatic cholangiocarcinoma: a case report and review of literature.Int J Clin Exp Pathol,3,736-741.
9. Hsu, HC,Chen, CC,Huang, GT(1996).Clonal Epstein-Barr virus associated cholangiocarcinoma with lymphoepithelioma-like component.Hum Pathol,27,848-850.
10. Huang, Y,Tsung, JS,Lin, CW(2004).Intrahepatic cholangiocarcinoma with lymphoepithelioma-like carcinoma component.Ann Clin Lab Sci,34,476-480.
11. Hur, YH,Kim, HH,Koh, YS(2011).Lymphoepithelioma-like cholangiocarcinoma not associated with Epstein-Barr virus.ANZ J Surg,81,652-653.
12. Jeng, YM,Chen, CL,Hsu, HC(2001).Lymphoepithelioma-like cholangiocarcinoma: an Epstein-Barr virus-associated tumor.Am J Surg Pathol,25,516-520.
13. Kim, YC,Park, MS,Chung, YE(2010).MRI findings of uncommon non-hepatocyte origin primary liver tumours with pathological correlation.Br J Radiol,83,1080-1086.
14. Lee, W(2011).Intrahepatic lymphoepithelioma-like cholangiocarcinoma not associated with epstein-barr virus: a case report.Case Rep Oncol,4,68-73.
15. Liver Cancer Study Group of Japan(1997).Classification of primary liver cancer.Tokyo, Japan:Kanehara-Shuppan.
16. Maetani, Y,Itoh, K,Watanabe, C(2001).MR imaging of intrahepatic cholangiocarcinoma with pathologic correlation.AJR Am J Roentgenol,176,1499-1507.
17. Manfredi, R,Barbaro, B,Masselli, G(2004).Magnetic resonance imaging of cholangiocarcinoma.Semin Liver Dis,24,155-164.
18. Ortiz, MR,Garijo, G,Adrados, M(2000).Epstein-Barr Virus-Associated Cholangiocarcinoma with Lymphoepithelioma-Like Component.Int J Surg Pathol,8,347-351.
19. Park, HS,Lee, JM,Choi, JY(2008).Preoperative evaluation of bile duct cancer: MRI combined with MR cholangiopancreatography versus MDCT with direct cholangiography.AJR Am J Roentgenol,190,396-405.
20. Ros, PR,Buck, JL,Goodman, ZD(1988).Intrahepatic cholangiocarcinoma: radiologic-pathologic correlation.Radiology,167,689-693.
21. Szekely, E(2001).Lymphoepithelioma-like cholangiocarcinoma (LELC) not associated with Epstein-Barr virus.Am J Surg Pathol,25,1464-1466.
22. Wernecke, K,Henke, L,Vassallo, P(1992).Pathologic explanation for hypoechoic halo seen on sonograms of malignant liver tumors: an in vitro correlative study.AJR Am J Roentgenol,159,1011-1016.
23. Wibulpolprasert, B,Dhiensiri, T(1992).Peripheral cholangiocarcinoma: sonographic evaluation.J Clin Ultrasound,20,303-314.