住野 泰清¹, 山室 渡¹, 羽鳥 知樹¹, 中川 和彦¹, 保坂 洋夫¹, 川田 典子², 秋間 道夫³

Yasukiyo SUMINO¹, Wataru YAMAMURO¹, Tomoki HATORI¹, Kazuhiko NAKAGAWA¹, Hiroo HOSAKA¹, Noriko KAWADA², Michio AKIMA³

¹東邦大学医学部第二内科, ²東邦大学医学部超音波検査室, ³東邦大学医学部第一病理

¹Department of 2nd. Internal Medicine, School of Medicine, Toho University, ²Ultrasonic Laboratory, School of Medicine, Toho University, ³Department of 1st. Pathology, School of Medicine, Toho University

キーワード : Ultrasonography, Intrahepatic malignant tumor, Marginal echogram of tumor, ultrasonographic-Pathologic correlation

The marginal features of the tumors on echograms were studied in 222 cases with intrahepatic tumors(hepatoma: 92 cases, metastatic liver cancer: 130 cases), and these features were also compared with histological changes in 42 cases (hepatoma: 15 cases, metastatic liver cancer: 27 cases). In the tumors with hypoechoic zone around its margin, the cancer cells at the edge were well preserved and necrosis of the cancer cells were minimal (Type I). Tumors with sharp margins lacking hypo-echoic zones around, generally showed moderate degrees of necrosis and augmented interstitial tissue growth at their edge of tumors (Type II). In the tumors which had no clear demarcated margins, the cancer cells were irregularly infiltrated into liver tissue (Type III). These changes were seen both in hepatoma and metastatic liver cancers. However, the tumor, which showed a thin hyper-echoic zone around the margin, had a thin fibrous capsule. This capsule was seen very frequently in hepatoma. It was concluded that the histological features of the margin of intrahepatic tumors determined the changes of its marginal echographic patterns and a thin hyper-echoic zone was a characteristic echographic finding of hepatoma with a thin fibrous capsule.