摘要
目的 总结食管错构瘤的影像学特征.方法 回顾性分析2010年10月吉林大学第一医院收治的1例食管错构瘤患者的临床资料,给予X线钡剂造影、多排螺旋CT平扫及二期增强扫描、食管镜、EUS检查,完善检查后行内镜下肿瘤切除术.术后复查X线钡剂造影.结果 X线钡剂造影检查示食管上段分叶状充盈缺损,表面光滑,食管黏膜连续,局部食管蠕动正常.食管CT检查示食管腔内见分叶状软组织密度影,大小约4.2cm×1.6 cm×1.5 cm,其内密度不均,中间密度近似脂肪样密度;二期增强扫描未见明确强化.食管镜检查示距门齿16 - 23 cm处见纵行隆起型粉白色肿瘤,近侧有蒂起源于食管后壁,远端呈结节样隆起,表面颗粒样粗糙,触之柔软,无出血,病变局部管腔狭窄.EUS检查示病灶呈不均质低回声,固有基层增厚明显,外膜边缘粗糙.患者行内镜下肿瘤切除术,术后病理学诊断为错构瘤.术后随访12个月,患者状况良好,复查X线钡剂造影,未见肿瘤复发.结论 食管错构瘤是一种极罕见的良性肿瘤,以进食固体食物出现哽咽感为主要临床表现.CT增强扫描及EUS检查对诊断、鉴别该病变具有重要的意义.
Objective To summarize the imaging features of esophageal hamartoma.Methods The clinical data of 1 patient with esophageal hamartoma who was admitted to the First Hospital of Jilin University in October 2010 were retrospectively analyzed.The patient received the X-ray barium meal examination,plain and enhanced multi-slice computed tomography （MSCT）,esophagoscopy and endoscopic ultrasonography （EUS）,and then the imaging features of those were analyzed.The patient underwent endoscopic resection of esophageal hamartoma and postoperative X-ray barium meal reexamination.Results X-ray barium meal examination demonstrated a lobular filling defect and smooth surfaces in the upper third of the esophagus,intact esophageal mucosa with good creeping.MSCT in esophagus showed a lobular soft-tissue density with the uneven inner density and liparod middle density with the size of 4.2 cm × 1.6 cm × 1.5 cm.There was no significant enhancement by enhanced CT scan.The irregular mass of white tumor at insicors 16-23 cm was observed by esophagoscopy,its proximal end was pedunculated and its nodular distally was rough,soft without bleeding and with a luminal stenosis of the local lesions.EUS revealed that there were a heterogeneous and hypoechoic lesion and the rough edge of adventitious coat of esophagus.The patient underwent endoscopic resection of tumor and was confirmed as with esophageal hamartoma by postoperative pathological diagnosis.The patient was followed up for 12 months with a good condition and without tumor recurrence by X-ray barium meal examination.Conclusions Esophageal hamartoma is a rare benign tumor,and its main clinical presentation is chocked fealing when patients take solid food.Enhanced CT scan and EUS are of great significance for the diagnosis of this disease.
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2015年第2期164-166,共3页
Chinese Journal of Digestive Surgery
