摘要
目的探讨骨外尤文肉瘤/原始神经外胚层肿瘤CT及MRI表现和病理特点,以提高对该病的认识。方法回顾性分析10例经病理证实的骨外尤文肉瘤/原始神经外胚层肿瘤CT及MRI表现,并复习相关文献。结果病灶位于颌下1例,颅内1例,胸膜1例,胸壁1例,胃部1例,肾脏3例,腹膜后1例,椎管内1例。病变均表现为体积较大并伴周围组织浸润肿块,CT呈等低密度,MRI呈T1WI等低、T2WI混杂信号,增强扫描表现为不同程度渐近性强化,5例高b值DWI扩散受限,8例伴囊变坏死,仅1例胸壁病灶伴钙化及邻近骨质轻微破坏,第三脑室、胃窦部及椎管内病灶体积大但梗阻不明显,肾脏及腹膜后病灶直径>10 cm,同时肾脏病变均伴有同侧肾静脉及下腔静脉癌栓。肿瘤免疫组织化学染色CD99弥漫性阳性表达。结论骨外尤文肉瘤/原始神经外胚层肿瘤多为体积较大的侵袭性软组织肿块,病灶内坏死、囊变多见,钙化少见,发生于肾脏病灶极易合并肾静脉及下静脉癌栓。
Objective To investigate CT and MRI manifestation and pathological features of extraskeletal Ewing's sarco⁃ma/primitive neuroectodermal tumor(EES/PNET),in order to improve the understanding level of the disease.Methods 10 cases of EES/PNET confirmed by pathology were diagnosed retrospectively.Results The lesions were located as fol⁃lows:submaxillary,cerebrum,pleura,chest wall,gastric,retroperitoneum and spinal canal were respectively in one case,and three cases were in renal.All lesions were characterized as large invasive soft tissue masses,with low density on CT and iso⁃dense or slight low signal on T1 WI and mixed signal on T2 WI and various level of asymptotic enhancement.Five cases showed restricted diffusion on high b⁃value DWI.Eight cases were with cystic necrosis.One case located on chest wall was with calcification and adjacent bone destruction.The lesions in the third ventricle,gastric antrum and spinal canal were large but the obstruction was not obvious.The diameter were more than 10cm occurred in kidney and retroperitoneum,and while the tumor occurred in the kidney,tumor thrombus in the ipsilateral renal vein and inferior vena cava can be observed.Tumor immunohistochemical staining showed diffuse and positive expression of CD99 in all cases.Conclusion EES/PNET were usually large and aggressive soft tissue mass,which were often accompanied with cystic necrosis and lack of calcification.EES/PNET of the kidney was very easy to be accompanied by tumor thrombus of renal vein and inferior vein.
作者
叶宇
文斐
伍勇
YE Yu;WEN Fei;WU Yong(Department of Radiology,Huangshi Central Hospital,Affiliated Hospital of Hubei Polytechnic University,Huangshi,Hubei Province 435000,P.R.China)
出处
《临床放射学杂志》
北大核心
2023年第9期1519-1522,共4页
Journal of Clinical Radiology
关键词
骨外
尤文肉瘤/原始神经外胚层
体层摄影术
X线计算机
磁共振成像
Extraskeletal Ewing's sarcoma/primitive neuroectodermal tumor
Tomography,X⁃ray computed
Magnet⁃ic resonance imaging
作者简介
通讯作者:伍勇。
