
浏览全部资源
扫码关注微信
1. 复旦大学附属肿瘤医院闵行分院放射科,上海,200240
2. 徐汇区康健街道社区卫生服务中心影像科,上海,200030
3. 复旦大学附属肿瘤医院放射诊断科,复旦大学上海医学院肿瘤学系,上海,200032
网络出版:2022-06-28,
纸质出版:2022-06-28
移动端阅览
胡冠男,周良平,周正荣,等. 腹盆腔促纤维组织增生性小圆细胞瘤的临床、影像学和病理学特征分析[J]. 肿瘤影像学, 2022, 31(3): 309-315 https://doi.
org/10.19732/j.cnki.2096-6210.2022.03.015
胡冠男,周良平,周正荣,等. 腹盆腔促纤维组织增生性小圆细胞瘤的临床、影像学和病理学特征分析[J]. 肿瘤影像学, 2022, 31(3): 309-315 https://doi. DOI: 10.19732/j.cnki.2096-6210.2022.03.015.
org/10.19732/j.cnki.2096-6210.2022.03.015 DOI:
目的:
探讨促结缔组织增生性小圆细胞肿瘤(desmoplastic small round cell tumor,DSRCT)的临床、影像学及病理学特征。
方法:
回顾并分析经复旦大学肿瘤医院病理学检查证实的30例DSRCT患者的临床资料、影像学及病理学特特征,并对其表现进行特征性分析。
结果:
30例患者中男性22例,女性8例,发病年龄17~49岁,中位年龄32岁。临床首发症状为腹部肿块11例(36.7%),30例患者中20例为首发患者,9例为术后复发,1例仅肿块切除术后未随访。此29例中,因1例患者以正电子发射体层成像(positron emission tomography,PET)为首诊方式,故选取28例中有计算机体层成像(computed tomography,CT)或磁共振成像(magnetic resonance imaging,MRI)影像学资料的患者进行评估,CT及MRI检查肿块分布于大网膜22例(78.6%)、小网膜12例(42.9%)、系膜间隙13例(46.4%);累及脏器包膜者,肝包膜下17例(60.7%)、脾包膜下6例(21.4%),其他脏器包膜6例(21.4%)。28例患者中有25例行CT增强检查,13例患者肿块内出现液化坏死(52.0%),6例患者肿块内出现钙化灶(24.0%)。肿块液化坏死区CT值为-4.9~40.5 HU(平均值17.8 HU),实性成分增强扫描前后CT值分别为17.8~41.6 HU(平均值38.6HU)及41.6~105.4 HU(平均值73.5 HU);6例患者行MRI检查,腹盆腔无明显脏器起源多发结节及肿块影,以网膜系膜居多,T1加权成像(T1-weighted imaging)呈等低信号,T2加权成像(T2-weighted imaging)呈混杂高信号,液化坏死呈高信号,弥散加权成像(diffusion-weighted imaging,DWI)呈高信号,动态增强呈轻中度不均匀强化。免疫组织化学分析显示弥漫强阳性表达广谱细胞角蛋白AE1/AE3(76.7%)、波形蛋白Vimentin(56.7%)及结蛋白Desmin(76.7%)。
结论:
DSRCT好发于青年男性,影像学检查多表现为腹腔网膜系膜或脏器间隙内多发弥漫性的肿块、膀胱直肠间隙肿块,无明确脏器起源,可囊变坏死、钙化,增强扫描呈轻中度不均匀延迟强化。临床、影像学及病理学相结合有助提高对这种罕见疾病的认识。
Objective:
To investigate the clinical
imaging and pathological features of desmoplastic small round cell tumor (DSRCT).
Methods:
The clinical data
imaging and pathological features of 30 DSRCT patients confirmed by pathology in Fudan University Cancer Hospital were retrospectively analyzed
and their manifestations were characterized.
Results:
Among the 30 cases
22 were male and 8 were female
Age 17-49 years
and the median age was 32 years. The first clinical symptom was abdominal mass in 11 cases (36.7%). Of the 30 patients
20 were first-time patients
9 cases were postoperative recurrence
and 1 case was not followed up after mass resection. Of the 29 cases
because one patient took positron emission tomography (PET) as the firstdiagnosis. Therefore
28 patients with computed tomography (CT) or magnetic resonance imaging (MRI) imaging data were selected for evaluation. CT and MRI showed that the mass was located in the greater omentum in 22 cases (78.6%)
the lesser omentum in 12 cases (42.9%)
and the mesenteric space in 13 cases (46.4%). Among the involved organ envelopes
17 cases (60.7%) were subhepatic
6 cases (21.4%) were subsplenic
and 6 cases (21.4%) were other organ envelopes. 25 of 28 patients underwent CT enhancement
liquefaction necrosis in 13 cases (52.0%)
calcification in 6 patients (24.0%). The CT value of the liquefied and necrotic area of the mass was -4.9-40.5 HU (average 17.8 HU)
and the CT values of the solid component before and after enhancement were 17.8-41.6 HU (average 38.6 HU) and 41.6-105.4 HU (average 73.5 HU). Six patients underwent MRI examination
and the abdominal and pelvic cavity showed no obvious organ origin
multiple nodules and mass shadows
mostly the mesentery. T1- weighted imaging (T1WI) showed equal low signal; T2-weighted imaging (T2WI) showed mixed high signal; liquefied necrosis showed high signal; diffusion-weighted imaging (DWI) showed high signal; dynamic enhancement showed mil
d to moderate heterogeneous enhancement. Diffuse strong positive expression of broad-spectrum cytokeratin AE1/AE3 by immunohistochemistry (76.7%)
Vimentin VIM (56.7%) and Desmin (76.7%). Immunohistochemical diffuse strong positive expression AE1/AE39(76.7%)
vimentin (56.7%) and junction protein (76.7%).
Conclusion:
DSRCT usually occurs in young men. Most of the images show multiple diffuse masses in the mesangial or organ space of the abdominal omentum
bladder and rectum space mass
no definite organ origin
cystic necrosis
calcification
enhanced scanning light and moderate uneven delayed enhancement. The combination of clinical
imaging and pathology could help to improve the understanding of DSRCT.
0
浏览量
1144
下载量
1
CNKI被引量
关联资源
相关文章
相关作者
相关机构
京公网安备11010802024621