MSCT诊断恶性食管血管球瘤临床案例分析

罗丹丹; 刘俊豪; 游玉峰; 雷震; 胡兴荣

doi:10.15953/j.ctta.2025.017

MSCT诊断恶性食管血管球瘤临床案例分析

罗丹丹^1,,
刘俊豪^{1, 2},
游玉峰¹,
雷震¹,
胡兴荣^1, ,

1.
恩施土家族苗族自治州中心医院，湖北恩施 445000
2.
湖北医药学院，湖北十堰 442000

详细信息

作者简介:
罗丹丹，女，硕士，恩施土家族苗族自治州中心医院放射影像科主治医师，主要从事从事放射影像学研究，E-mail：249236759@qq.com

通讯作者:
胡兴荣✉，硕士，恩施土家族苗族自治州中心医院放射影像科主任、主任医师、教授，湖北民族大学及湖北医药学院硕士研究生导师，主要从事放射影像学研究，E-mail：xrh_cct@126.com。

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出版历程
- 收稿日期: 2025-01-08
- 修回日期: 2025-02-20
- 录用日期: 2025-03-05
- 网络出版日期: 2025-03-30

Clinical Case Analysis of Esophageal Malignant Glomus Tumor Diagnosed by MSCT

1.
Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi 445000, China
2.
Hubei University of Medicine, Shiyan 442000, China

摘要

摘要:
食管恶性血管球瘤罕见，临床特征及影像学表现缺乏特异性，术前鉴别诊断困难，影响临床治疗决策。本文报道 1 例我院收治的食管恶性血管球瘤术后6年肝内多发转移的患者，回顾性分析该病例的临床资料及影像学表现，旨在提高影像科医师对食管血管球瘤CT表现的认识，为临床诊治提供帮助。
- 体层摄影术 /
- X 线计算机 /
- 血管球瘤 /
- 食管
Abstract:
Esophageal malignant glomus tumors are rare, and their clinical features and imaging manifestations lack specificity. Preoperative differential diagnosis is difficult, which affects clinical treatment decisions. This article reports a case of a patient with multiple intrahepatic metastases of esophageal malignant glomus tumor admitted to our hospital six years after surgery. The clinical data and imaging findings of this case were retrospectively analyzed to improve the understanding of CT manifestations of esophageal glomus tumors by radiologists and provide assistance for clinical diagnosis and treatment.
- tomography /
- X-ray computed /
- glomus tumor /
- esophagus

HTML全文

图 1 电子胃镜图像

注：图1食管距门齿约35~38 cm可见隆起样病变，表面光滑，官腔狭窄。

Figure 1. Electronic gastroscope image

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图 2 上消化道造影图像

注：图2上消化道造影充盈像（a），食管下段胸11-12椎体水平外压性改变。上消化道造影黏膜像（b）黏膜光滑，未见增粗和中断。

Figure 2. Gastroenterography image

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图 3 胸部CT平扫及增强图像

注：平扫（a）左后下纵隔食管下段后外侧外生性团块状囊实性占位；增强动脉期（b）病灶毗邻胸主动脉，实性部分明显强化并显示多发小血管影穿行；静脉期（c）病灶实性部分持续强化；轴位MIP重建（d）显示病灶多发迂曲细小血管影；冠状位重建（e）病灶位于食管外侧，压迫下段食管及胃底，黑箭显示食管黏膜线样强化，箭头显示胃底；动脉期VR（f）重建显示病灶由增粗的胃左动脉供血。

Figure 3. Plain and contrast-enhanced chest CT images

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图 4 术后病理

注：大体病理图像（a）灰白结节样肿物多切面切开灰白、实性、质中，较韧，可见散在点状暗红色区；HE染色（×100）（b）瘤细胞丰富，部分区域呈实性巢团状，部分区域呈条束状排列，瘤细胞分布于大小不一的血管周围，其内可见丰富的血管，呈分支状或鹿角状，呈血管外皮瘤样结构；HE染色（×400）（c）瘤细胞有明显异型性，细胞核深染。

Figure 4. Pathological images of lesions

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图 5 腹部CT平扫图像

注：肝内多发大小不等稍低、低混杂密度结节及团块。

Figure 5. Plain abdominal CT images

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