{"created":"2023-06-19T10:43:31.018585+00:00","id":3754,"links":{},"metadata":{"_buckets":{"deposit":"ab4570a2-21d9-4123-abb1-e56cb6aba202"},"_deposit":{"created_by":11,"id":"3754","owners":[11],"pid":{"revision_id":0,"type":"depid","value":"3754"},"status":"published"},"_oai":{"id":"oai:shiga-med.repo.nii.ac.jp:00003754","sets":["6:7:371:372"]},"author_link":["6959","696","8222","8289","6759","844","8220","8221","811","887","3245","8218","6906","7460","812","6933","629","3247","627"],"item_3_alternative_title_19":{"attribute_name":"タイトル（ヨミ）","attribute_value_mlt":[{"subitem_alternative_title":"カンサイボウガン ト カンベツ ガ コンナンデアッタ カンケッカンキン シボウシュ ノ １レイ"}]},"item_3_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2020-11-30","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"9","bibliographicPageStart":"5","bibliographicVolumeNumber":"34","bibliographic_titles":[{"bibliographic_title":"滋賀医科大学雑誌"}]}]},"item_3_creator_3":{"attribute_name":"著者別名","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"HAGINO, Motoharu"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"IIDA, Hiroya"}],"nameIdentifiers":[{},{},{}]},{"creatorNames":[{"creatorName":"MAEHIRA, Hiromitsu"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"MORI, Haruki"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"KAIDA, Sachiko"}],"nameIdentifiers":[{},{},{}]},{"creatorNames":[{"creatorName":"ISHIKAWA, Ken"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"TAKEBAYASHI, Katsushi"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"TOKUDA, Aya"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"MIYAKE, Toru"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"UEKI, Tomoyuki"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"KOJIMA, Masatsugu"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"KODAMA, Hirokazu"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"SHIOMI, Motonori"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"MAEKAWA, Takeru"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"MURAMOTO, Keiji"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"FUKUO, Asuka"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"YAMAGUCHI, Tsuyoshi"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"MORITANI, Suzuko"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"TANI, Masaji"}],"nameIdentifiers":[{},{},{}]}]},"item_3_description_4":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"肝原発の血管筋脂肪腫（angiomyolipoma; AML）は、肝細胞癌と鑑別が困難な場合がある。今回、単発の肝腫瘍に対して肝細胞癌を否定できず切除を行ったが、病理組織学的検査でAMLと診断した一例を経験したので報告する。症例は50歳代の女性。検診にて外側区域の肝腫瘍を指摘され、加療目的に紹介となった。造影CT検査では肝外側区域、門脈臍部に接して2cm大の腫瘍性病変を認め、動脈相で濃染し平衡相でwashoutしていた。腹部MRI検査では同部位にT2強調像で高信号、T1 out of phaseにて若干の信号低下を認めた。Gadolinium-ethoxybenzyl-diethylene-triaminepentaacetic-acid(Gd-EOB-DTPA; EOB) MRIでは動脈相で濃染、門脈相から平衡相にかけてwashoutし、肝細胞相では低信号であった。画像所見から肝細胞癌を疑い、腹腔鏡下肝左葉切除術を施行した。病理組織学的には好酸性紡錘形細胞や淡明～淡好酸性細胞の上皮様配列がみられ、内部に脂肪組織が島状に介在し、また、平滑筋性の厚い壁を持った血管構造も一部存在しており、肝血管筋脂肪腫と診断した。一般に脂肪成分の少ないAMLは、肝細胞癌との鑑別が困難である。最近では、肝静脈への流出血管の有無が鑑別診断に有用であるとの報告が見られるため、これらを注意深く観察すべきと考えられた。","subitem_description_type":"Abstract"},{"subitem_description":"Hepatic angiomyolipoma (AML) may be difficult to distinguish from hepatocellular carcinoma. Here we report a resected case of a hepatic AML mimicking hepatocellular carcinoma. The patient was a woman in her 50s referred for further evaluation of a tumor in the left lateral segment of the liver. Contrast-enhanced computed tomography showed a two cm-sized tumor attached with the umbilical portion in the left lateral segment of the liver, which was enhanced in the arterial phase and washed out in the portal venous phase. Abdominal MRI showed a high-intensity tumor on T2-weighted image and a slight decrease of signal intensity on T1 out of phase. The tumor on Gd-EOB-DTPA enhanced MRI displayed high intensity in the arterial phase and washout in the portal venous phase, and low signal intensity in hepatobiliary phase. Based on these imaging findings, we suspected hepatocellular carcinoma and a laparoscopic left lobectomy was performed. Histopathological examination showed spindle and perivascular epithelioid cells and a few fat cells, and immunohistochemical analysis revealed positive staining of HMB-45 and αSMA. The tumor was diagnosed as a hepatic AML. Hepatic AML with a small fatty component is generally difficult to distinguish from hepatocellular carcinoma. More recently, the presence of outflow blood vessels to the hepatic vein has been reported to be useful in the differential diagnosis for AML. These imaging findings should be carefully observed.","subitem_description_type":"Abstract"}]},"item_3_description_42":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"subitem_description":"Departmental Bulletin Paper","subitem_description_type":"Other"}]},"item_3_identifier_registration":{"attribute_name":"ID登録","attribute_value_mlt":[{"subitem_identifier_reg_text":"10.14999/1521.00012864","subitem_identifier_reg_type":"JaLC"}]},"item_3_publisher_32":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"滋賀医科大学雑誌編集委員会"}]},"item_3_relation_11":{"attribute_name":"DOI","attribute_value_mlt":[{"subitem_relation_name":[{"subitem_relation_name_text":"10.14999/1521.00012864"}],"subitem_relation_type":"isIdenticalTo","subitem_relation_type_id":{"subitem_relation_type_id_text":"http://doi.org/10.14999/1521.00012864","subitem_relation_type_select":"DOI"}}]},"item_3_version_type_15":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"萩野, 元晴"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"飯田, 洋也"}],"nameIdentifiers":[{},{},{}]},{"creatorNames":[{"creatorName":"前平, 博充"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"森, 治樹"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"貝田, 佐知子"}],"nameIdentifiers":[{},{},{}]},{"creatorNames":[{"creatorName":"石川, 健"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"竹林, 克士"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"徳田, 彩"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"三宅, 亨"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"植木, 智之"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"小島, 正継"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"児玉, 泰一"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"塩見, 一徳"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"前川, 毅"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"村本, 圭史"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"福尾, 飛翔"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"山口, 剛"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"森谷, 鈴子"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"谷, 眞至"}],"nameIdentifiers":[{},{},{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2020-12-01"}],"displaytype":"detail","filename":"jsums3401p005.pdf","filesize":[{"value":"1.4 MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"jsums3401p005","url":"https://shiga-med.repo.nii.ac.jp/record/3754/files/jsums3401p005.pdf"},"version_id":"2f150c37-2cae-41ce-80e7-aaa2f92f763f"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"肝血管筋脂肪腫","subitem_subject_scheme":"Other"},{"subitem_subject":"肝細胞癌","subitem_subject_scheme":"Other"},{"subitem_subject":"流出静脈","subitem_subject_scheme":"Other"},{"subitem_subject":"Angiomyolipoma","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"hepatocellular carcinoma","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"drainage vein","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"departmental bulletin paper","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"肝細胞癌と鑑別が困難であった肝血管筋脂肪腫の１例","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"肝細胞癌と鑑別が困難であった肝血管筋脂肪腫の１例"},{"subitem_title":"A Case of Hepatic Angiomyolipoma Mimicking Hepatocellular Carcinoma.","subitem_title_language":"en"}]},"item_type_id":"3","owner":"11","path":["372"],"pubdate":{"attribute_name":"公開日","attribute_value":"2020-12-01"},"publish_date":"2020-12-01","publish_status":"0","recid":"3754","relation_version_is_last":true,"title":["肝細胞癌と鑑別が困難であった肝血管筋脂肪腫の１例"],"weko_creator_id":"11","weko_shared_id":-1},"updated":"2023-06-19T11:14:44.231511+00:00"}