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基于病理分型的腹部炎性肌纤维母细胞瘤的CT表现

作者:李秀丽 任 静 程祝忠 许国辉 周 鹏

所属单位:四川省肿瘤医院影像科(四川 成都 610041)

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摘要

目的 探讨腹部炎性肌纤维母细 胞瘤(IMT)的病理及CT表现,提高对该病 的诊断。方法 对12例经手术病理证实的 腹部IMT的CT及临床资料进行回顾性分 析。结果 12例IMT中,位于肝脏3例、胃1 例、直肠1例、肠系膜及腹膜3例、腹膜后 4例;病变均边界清楚,呈圆形或类圆形 或不规则型,最大直径约2.5-17.0cm;8 例呈实性肿块,4例呈囊实性肿块。CT平 扫所有病例的实性部分呈等或低密度,增 强后,6例呈稍不均匀中等强化,2例呈均 匀强化,4例囊实性肿块的实性部分明显 强化。结论 腹部IMT除具有病变边界清 楚,呈圆形、类圆形或不规则形等共同特 征外,不同病理类型病灶CT表现具有一定 的个性特征,CT对其诊断及病理分型具有 一定价值。

Objective To investigate the CT characters and corresponding pathological bases of abdominal inflammatory myofibroblastic tumor (IMT). Methods The CT and clinical data of 12 IMT cases confirmed by surgery and pathology were analyzed retrospectively. Results Among 12 cases, 3 cases were found in liver, 1 case in stomach, 1 case in rectum, 3 case in mesentery and peritoneum, and 4 in retroperitoneum. The tumors showed welldefinded round or similar round or irregular in shape. The range of maximum diameter was 2.5 to 17.0 cm. CT presented solid mass in 8 cases, cystic and solid mass in 4 cases. The solid part of all the cases showed hypodense or isodense on non-enhanced CT. The enhancement patterns of 12 cases were various, 6 cases showed heterogeneous moderate enhancement, 2 cases showed homogeneous enhancement, the solid part of 4 cases with cystic and solid tumors showed marked enhancement. Conclusion The CT findings of abdominal IMT show certain common characters like round, similar round or irregular mass with well-definded margin. The enhanced CT of different pathological types can show certain individual characters, which may provide some values for the diagnosis and pathological types.

【关键词】炎性肌纤维母细胞瘤;体层摄 影术,X线计算机;腹部肿瘤

【中图分类号】R735.5 ;R445.3

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2019.05.028

前言

炎性肌纤维母细胞瘤(inflammatory myofibroblastic tumor IMT),是由分化的肌纤维母细胞性梭形细胞组成的,常伴有大量浆细 胞和(或)淋巴细胞的一种肿瘤。它是一种少见而又独特的间叶性肿 瘤,Brunn首次描述了该肿瘤,称为炎性假瘤[1]。近年来其疾病本质被 逐渐认识,在2002被WHO正式命名为真性肿瘤。该病好发于儿童及青 年,常常累及肺[2],而发生于腹部肝脏、胃肠道、腹膜后的病变非常罕 见,且发生于这些部位病变常常被误诊。本文分析12例腹部IMT的CT表 现及临床病理资料,以提高对本病诊断。