论著-头颈部
骨盆孤立性浆细胞瘤的临床及影像表现分析
作者:罗振东1 陈卫国2 沈新平1 贾 铭2 秦耿耿2 吕建勋1
所属单位:1.香港大学深圳医院放射医学中心 (广东 深圳 518133) 2.南方医科大学南方医院放射科 (广东 广州 510515)
PDF摘要
目的 分析骨盆孤立性浆细胞瘤 的临床及影像表现特点。方法 经手术病 理证实的18例骨盆孤立性浆细胞瘤,16例 行X线检查,7例行CT检查,14例行MRI检 查。结果 (1)临床表现:男性10例,女性 8例,发病年龄44-79岁,平均年龄60.1 岁。(2)X线、CT表现:孤立性浆细胞瘤18 例中,16例表现为溶骨性骨质破坏合并软 组织肿块,2例为膨胀性骨质破坏,10例 病灶内可见残存的硬化骨嵴及边缘出现硬 化。(3)MRI表现为正常骨髓信号被肿瘤取 代,10例形成信号相对均匀的软组织肿 块,4例软组织肿块信号不均。T1WI上病 灶表现为等信号6例、稍高信号8例,T2WI 病灶均表现为高或稍高信号,10例瘤周存 在水肿,增强扫描均明显强化。结论 骨 盆是骨孤立性浆细胞的少见部位,好发于 老年患者,其影像表现具有一定特征性。
Objective The objective was to characterize clinical manifestation and imaging findings of solitary plasmacytoma in pelvic bones. Methods Clinical and imaging data for solitary plasmacytoma of pelvic bones in 18 patients were reviewed retrospectively. Conventional radiographs (n=16), computed tomographic images (n=7), and magnetic resonance images (n=14) were reviewed. All the patients were stained with hematoxylineosin and microscopically examined. Results There were eight female and 10 male patients with an age range of 44 to 79 years (average age, 60.1 years). 16 cases showed the cortical disruption with soft tissue mass,the other two cases showed expansive destruction of bone.10 cases showed the cortical disruption with rim osteosclerosis and bony septations. All the cases that had MRI examination showed normal marrow being replaced by tumors and 10 cases had extra-osseous soft tissue mass. The affected bone marrow and soft tissue mass showed isointensity six cases and slightly hyperintensity eight cases relative to muscles. T2-weighted MR images revealed hyperintensity with peritumoral edema. GadoliniumDTPA-enhanced T1-weighted MR images showed significant enhancement in 10 cases. Conclusion Solitary plasmacytoma in pelvic bones is rare, it mainly occurred in elderly patients.Solitary plasmacytoma in pelvis bones have characteristic images that it is important for its diagnosis and differential diagnosis.
【关键词】浆细胞瘤;骨盆;肿瘤;体层 摄影术,X线计算机
【中图分类号】R826.67
【文献标识码】A
【DOI】10.3969/j.issn.1672- 5131.2017.08.039
前言
含造血性红骨髓的部位均可发生浆细胞瘤,骨盆骨为孤立性浆细 胞瘤的少见部位,较易误诊为骨盆常见的恶性肉瘤。目前对骨盆孤立 性浆细胞瘤的影像表现认识仍存在不足,误诊率较高,为进一步加深 对该病的认识,搜集了2005年1月~2015年12月经手术或穿刺活检病理 证实的骨盆孤立性浆细胞瘤18例,综合分析它们的临床及影像表现, 以期对诊断、鉴别诊断提供有利的依据。
中国CT和MRI杂志
第15卷, 第 8 期
2017年08月
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