摘要:
目的:分析腹膜后间质瘤的临床、病理组织学特征及MSCT表现,探讨MSCT对本病的诊断价值。方法:回顾性分析经手术和病理证实的12例腹膜后间质瘤的临床及MSCT资料,所有病例术前均进行了CT平扫及增强检查。结果:12例患者中,男性7例,女性5例,40岁以上8例,平均年龄55岁,主要临床表现为腹部肿块和疼痛。12例均表现为腹膜后腔软组织肿块,肿瘤最大直径3.0~21.0cm,平均11.0cm。肿瘤呈类圆形7例,不规则形5例。其中CT平扫密度均匀2例中,增强扫描1例均匀强化,另1例不均匀分隔状强化。CT平扫密度不均匀10例中均见囊变坏死区,其中钙化2例、出血2例,增强扫描实质部分中度以上强化,囊变坏死部分不强化,呈分隔状。病理结果提示良性1例,低度恶性潜能3例,恶性8例,远处转移3例。免疫组化表现CD117阳性12例,CD34阳性7例。结论:腹膜后间质瘤多见于中老年患者,临床症状少;MSCT表现具有一定特征,能较好地反映病变的病理组织学特点,对本病的诊断及鉴别诊断有重要价值。
Abstract:
Objective: To analyze the Clinical and pathological characteristics and MSCT manifestations of retroperitoneal stromal tumors,and investigate diagnostic value of MSCT for retroperitoneal stromal tumors.Methods: The clinical and CT date of 12 patients with retroperitoneal stromal tumors confirmed by operation and pathology were retrospectively reviewed.All patients underwent plain CT scans and contrast–enhanced CT scans before operation.Results: Among the 12 patients,7 were men and 5 were women,the ages ranged above 40 years old in 8 cases,mean age 55 years old.The major clinical symptom of the retroperitoneal stromal tumors were abdominal masses and bellyache.12 patients of retroperitoneal stromal tumors on CT showed retroperitoneal soft tissue masses,the biggest diameter of tumors ranged from 3.0 cm to 21.0 cm,mean 11.0 cm.The tumors were round or oval in 7 cases,irregular in 5cases.The tumors in 2 cases were uniform density on plain CT scans,1 case of uniform enhancement and 1 case of non-uniform linear enhancement on contrast—enhanced CT scans.10 cases showed unhomogeneous density on plain CT scans,low density necrosit in 10,hemorrhage in 2 and calcification in 2;moderate or remarkable enhancement was found in the parenchyma of the tumor,while no enhancement was found in the necrosis and cystic areas of the tumors on contrast—enhanced CT scans.There were benign tumour in 1,potential malignant tumours in 3 and malignant tumours in 8,metastases were found in 3 cases.In 12 cases,all were CD 117 positive,7 were CD 34 positive in immuinohistochemical test.Conclusion: The retroperitoneal stromal tumors usually involve middle-old,and clinical symptom is rare;the CT findings of the retroperitoneal stromal tumors display some characteristic signs and demonstrate the pathological features,which is very helpful in the diagnosis and differential diagnosis.
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