脊柱尤文肉瘤的临床及病理特征和MRI表现  

Ewing's sarcoma of vertebral column:clinical,pathological and MRI manifestations

作　　者：洪国斌[1] 梁碧玲[2] 邬伟明[3] 冯晓新[1] 谢玉妍[4] 

机构地区：[1]中山大学附属第五医院放射科,广东珠海519000 [2]中山大学附属第二医院放射科 [3]中山大学附属第五医院呼吸内科,广东珠海519000 [4]中山大学附属第五医院病理科,广东珠海519000

出　　处：《中华临床医师杂志（电子版）》2009年第7期54-56,共3页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的探讨脊柱尤文肉瘤的临床、病理及MRI特点。方法回顾性分析9例经手术病理或穿刺活检证实的脊柱尤文肉瘤的临床、病理特征及MRI表现。结果9例脊柱尤文肉瘤中,发生于颈椎、胸椎和腰椎各2例,骶椎3例。6例进行了MRI检查,均显示椎体骨骼信号异常,在T1WI上4例表现为中等信号,2例表现为稍低信号;在T2WI上表现为稍高信号,钆喷替酸葡甲胺(Gd-DTPA)增强后不均匀强化。3例表现为溶骨性骨质破坏、椎体压缩变扁;3例表现为椎体轻度膨胀性溶骨性破坏。相邻的椎间隙无狭窄、椎间盘信号无异常;均见周围明显的软组织肿块,增强后明显强化。HE染色并镜下观察肿瘤细胞均呈小圆形,不伴有Homer-Wright(H-W)菊形团排列;PAS染色阳性6例,NSE弱阳性2例。结论脊柱原发性尤文肉瘤的MRI表现有一定的特点,但缺乏特异性。当患者为儿童或青少年,且影像学表现为溶骨性骨质破坏伴明显的软组织肿块时需考虑尤文肉瘤的可能。Objective To analyze the clinical, pathological and MR imaging features of Ewing＇s sarcoma of vertebral column. Methods Nine cases of Ewing＇s sarcoma of vertebral column was proved by surgical or biopsy pathology. 6 of 9 patients underwent MR imaging. Their clinical and pathological features and MR imaging manifestations were retrospectively analyzed. Results In 6 patients with MR imaging, 2 tumors arose each in cervical, thoracic and lumbar vertebrae, respectively, the remaining 3 tumors in sacral vertebrae. The tumor showed isointensity in 4 cases and slight hypointensity in 2 cases on T1-weighted imaging, and heterogeneous hyperintensity signal on T2-weighted imaging and heterogeneously enhanced after contrast enhancement. Soft tissue mass were found in 6 tumors and no calcification and periosteal reaction were seen. Hematoxylin-Eosin staining demonstrated uniform small round cells in all cases and without Homer-Wright（H-W） rosettes. PAS staining were positive in 6 cases. 2 cases were slightly positive for NSE. Conclusions The Ewing＇s sarcoma of vertebral column has some characteristic manifestations but not pathognomonic on MR imaging. The Ewing＇s sarcoma of vertebral column should be reminded when the patients are children or adolescent, and the lesions show obviously osteolysis of vertebral body and a concurrent large soft tissue mass.

关 键 词：肉瘤 Ewing 磁共振成像 病理学 

分 类 号：R738.1[医药卫生—肿瘤]