摘要
目的探讨上皮样炎性肌纤维母细胞肉瘤(EIMS)的CT表现、诊断与鉴别诊断要点。方法总结8例腹腔及腹膜后EIMS的发病规律、发生部位、形态、平扫CT密度及增强强化类型,周边及其他继发表现特点,并复习相关文献。结果女3例,男5例。年龄8~42岁,平均(36±5.2)岁。CT表现为多发结节型、局限肿块型和弥漫型,累及部位包括脏壁层腹膜、肠系膜、大小网膜,中下腹部及盆腔居多。病灶多呈结节团簇状,形似葡萄串,可融合成大片匍匐于腹膜、网膜之中,呈冰冻腹腔改变。单个肿块可呈不规则形分叶,CT平扫呈高低混杂密度,较高部分可接近肌肉密度,较低部分略高于水样密度;单个结节病灶中心呈较低密度,高低密度之间分界不清,CT增强病灶强化也呈两极分化,平扫高密度部分血供丰富呈显著强化,平扫低密度部分早期轻度强化,后期可以持续性强化,病灶内部不同成分之间无截然分界,病灶与周边脏器亦黏连分界不清,符合浸润性生长方式,5例出现腹腔种植,7例患者有腹腔积液,主要分布于病灶周边和转移病变周围,呈瘤浸入水中表现。弥漫型仅做姑息性切除肿瘤减轻负荷,5例患者行根治手术,3例患者术后3个月肿瘤局部复发,并出现肝、肺、脑多发转移,导致多器官死亡。结论EIMS是炎性肌纤维母细胞瘤(IMT)罕见的恶性上皮样亚型,依据发生部位、典型的形态学和CT特点,特别是出现有腹腔多发团簇状结节,同时具有炎症和腹腔恶性肿瘤特点以及典型的CT强化特点时,应该想到该病的可能。
Objective To investigate the CT findings,diagnosis and differential diagnosis of epithelioid inflammatorymyofibroblastic sarcoma ( EIMT) . Methods The etiology,location,morphology,CT density and enhancement type,pe-ripheral and other secondary performance characteristics of 8 cases of abdominal and retroperitoneal EIMT were summa-rized. Results 3 females and 5 males. The patients were 8 to 42 years old with an average of ( 32 ± 6) years. The leftupper quadrant was painful for half a year,and the pain was aggravated with abdominal distension for 1 month. CT is divid-ed into localized mass type and diffuse type. The affected parts include the peritoneum of the visceral layer,the mesentery,the reticular formation,and the middle and lower abdomen and pelvis. Most of the lesions are clusters of clusters resemb-ling grape clusters,which can be fused into a large piece of sputum in the peritoneal omentum,which changes in frozen ab-dominal cavity. Individual lumps can be irregularly shaped,and CT scan showed high and low mixed density,the higherpart was close to muscle density,the lower part was slightly higher than the water sample density,the center of single nodu-lar lesion was lower density,the boundary between high and low density was unclear,and CT enhanced lesion enhancementIt is polarized,and the high-density part of the blood supply is markedly enhanced. The low-density part is mildly strength-ened in the early stage,and can be continuously strengthened in the later stage. There is no clear boundary between the dif-ferent components in the lesion,and the lesion and the surrounding organs also adhere to the boundary. Unclear,consistentwith invasive growth mode,diffuse lesions and single-shot mass can be implanted in the abdominal cavity,7 cases of pa-tients have ascites,mainly distributed around the lesion and around the metastatic lesion,showing tumor immersed in wa-ter. Diffuse type only to reduce the burden of femoral resection of the tumor,patients with local recurrence 3 months aftersurgery,and liver,lung,b
作者
陈丹
张亚林
瞿中威
周顺科
陈德强
姚景江
CHEN Dan;ZHANG Yalin;QU Zhongwei(Department of Radiology,Changsha Central Hospital,Changsha,Hunan Province 410004,P. R. China)
出处
《临床放射学杂志》
CSCD
北大核心
2018年第11期1848-1851,共4页
Journal of Clinical Radiology
