摘要
背景与目的:黏液纤维肉瘤(myxoid fibrosarcoma,MFS)是一种少见的恶性纤维源性软组织肿瘤,好发于老年人,四肢多见,侵袭性强,易复发。目前该肿瘤的诊断具有一定难度,影像学对确定软组织肿瘤是否为肉瘤及其恶性程度有一定可信性,但对肿瘤定性也只能作为参考。通过对黏液纤维肉瘤影像学表现、临床病理学特征分析,旨在提高MFS的诊断水平,进一步对其进行低、中、高度分级。方法:收集2019年1月—2021年2月在复旦大学附属肿瘤医院就诊的11例MFS以及在复旦大学附属肿瘤医院闵行分院就诊的22例MFS患者的影像学资料、临床及病理学资料,所有MFS患者均经手术后病理学检查证实。影像学资料:肿块的形态、大小、密度/信号、强化程度及对周围组织的浸润等征象;临床特征:患者的性别、年龄、易发病部位及就诊时的症状、体征等;病理学资料:根据所取病检组织中黏液、瘤细胞及纤维成分的比例、以及瘤细胞异型性大小、核分裂象多少来进行Ⅰ、Ⅱ、Ⅲ分级。结果:本研究中5例MFS为Ⅰ级,10例为Ⅱ~Ⅲ级,18例为Ⅲ级;其中10例肿瘤最大径≥5 cm,10例可见黏液样变,22例可见囊变坏死,30例可见尾征,27例可见双低信号征,23例可见瘤周水肿,低、中及高度MFS三组间大小、尾征、双低信号征差异无统计学意义(P>0.05);黏液样变、坏死囊变、瘤周水肿三组间差异有统计学意义(P<0.05)。结论:CT及MRI对MFS的定位、定性及分级与临床病理学特征具有相关性。
Background and purpose:Myxoid fibrosarcoma(MFS)is a rare malignant fibrogenic soft tissue tumor and more common in the elderly,which is highly invasive and prone to recurrence.At present,the diagnosis of this tumor is difficult to some extent.Imaging has a certain credibility for determining whether the soft tissue tumor is sarcoma and its malignancy,but it can only be used as a reference for the qualitative characterization of the tumor.The purpose of this study was to improve the diagnostic level of MFS by analyzing the imaging manifestations,clinical features and pathological correlation,and to further classify it into low,medium and high grade.Methods:From January 2019 to February 2021,imaging,clinical and pathological data of 11 patients with surgically proven MFS in the Fudan University Shanghai Cancer Center and 22 patients in the Minhang Branch of Fudan University Shanghai Cancer Center were collected.Imaging data was obtained through measurement of the tumor shape,size,density/signal,degree of enhancement and surrounding tissue infiltration and other signs.Clinical features included gender,age,prone site,symptoms and signs of patients.Pathology grading ofⅠ,ⅡandⅢwere performed according to the proportion of myxoid,tumor cells and fibrous components in the sampled tissues,as well as the size of tumor cell atypia and the number of mitotic figures.Results:In this study,5 patients had gradeⅠMFS,10 patients had gradeⅡ-ⅢMFS,and 18 patients had gradeⅢMFS.In 10 cases,the maximum diameter of the tumor was≥5 cm.Myxoid changes were observed in 10 cases.Cystic necrosis was observed in 22 cases.Tail sign was observed in 30 cases.Double hyposignal sign was observed in 27 cases,and peritumoral edema was observed in 23 cases.There was no significant difference in the size,tail sign and double hyposignal sign among the three groups of mild,moderate and high MFS(P>0.05).There were statistically significant differences in myxoid degeneration,necrotic cystic degeneration and peritumoral edema among the three
作者
罗容
胡培安
解添淞
张泽华
周良平
周正荣
陈雷
LUO Rong;HU Peian;XIE Tiansong;ZHANG Zehua;ZHOU Liangping;ZHOU Zhengrong;CHEN Lei(Department of Radiology,Minhang Branch,Fudan University Shanghai Cancer Center,Shanghai 200240,China;Department of Diagnostic Radiology,Children’s Hospital of Fudan University,Shanghai 200032,China;Department of Radiology,Fudan University Shanghai Cancer Center,Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China)
出处
《中国癌症杂志》
CAS
CSCD
北大核心
2021年第8期734-739,共6页
China Oncology
基金
上海市科学技术委员会科研计划项目(18140901200)
上海市闵行区医学特色专科建设项目(2020MWFC05)。
