胸部神经节细胞瘤影像学表现与病理分析  

Imaging manifestations and pathological analysis of intrathoracic ganglioneuroma

作　　者：梁辉清[1] 曾庆思[2] 唐堪华 刘海明[1] 黄锦钊[1] 杨剑[1] 

机构地区：[1]中山市陈星海医院放射科,广东中山528415 [2]广州医学院第一附属医院放射科,广东广州510120

出　　处：《中国医学影像技术》2013年第8期1288-1291,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨胸部神经节细胞瘤的影像学表现与病理特征。方法回顾性分析24例经手术病理证实的胸部神经节细胞瘤的影像学资料(其中18例接受CT检查,8例接受MR检查,2例同时接受CT及MR检查),并与组织病理学特征相对照分析。结果 18例神经节细胞瘤CT平扫呈低密度,CT值20～42HU,5例见钙化,2例可见小斑片状脂肪密度;增强后动脉期增强差值0～15HU,延迟后逐渐强化,增强差值12～35HU。接受MR检查的8例中,6例T1WI呈均匀低信号,2例低信号病灶内夹杂斑片状高信号;8例T2WI呈不均匀高信号,其中2例可见漩涡征;增强后动脉期呈轻度不均匀强化,延迟后逐渐进行性强化。病理示肿瘤组织主要由神经纤维、施万细胞、神经节细胞及黏液基质组成。免疫组化结果示肿瘤波形蛋白(+)、S-100(+)、神经元特异性烯醇化酶(+)、神经丝蛋白(+)及髓磷脂碱性蛋白(+)。结论胸部神经节细胞瘤的特征性影像学表现是动脉期不强化或轻微强化,延迟期逐渐强化;病理形态学观察及免疫组织化学检查可以明确诊断。Objective To investigate the image findings of intrathoracic ganglioneuroma comparing with pathological results. Methods Twenty-four patients with intrathoracic ganglioneuroma confirmed by operation and pathology were retrospectively analyzed. Eighteen patients underwent CT scan, 8 patients underwent MRI, and 2 patients underwent both CT and MRI. The image findings were analyzed and compared with pathological results. Results On plain CT, all 18 cases showed low density, and CT value ranged from 20 HU to 42 HU. Calcifications were detected in 5 cases, while fat density was found in 2 cases. After injection of contrast agent, CT value increased from 0 to 15 HU in artery phase. With gradual-increasing enhancement in delay phase, CT value increased from 12 HU to 35 HU. Among 8 cases underwent MRI, 6 cases showed homogeneously low signal on T1WI, 2 cases with fat signal and in-homogeneously high intensity on T1WI. Eight cases showed in-homogeneously high intensity on T2WI. Whirlpool sign was seen in 2 cases. Contrast enhanced MR images showed in-homogeneously enhancement in artery phase and gradual increasing enhancement in delay phase. Microscopically, the tumors were composed of nerve fibers, Schwann cells, ganglion cells and mucus matrix. Immunohistochemical staining showed that the tumors were positive with Vim, S-100, neuron-specific enolase, neurofilament and my elin basic protein. Conclusion The characteristic manifestations of intrathoracic ganglioneuroma include no enhancement or slight enhancement in artery phase and gradual-increasing enhancement in delay phase. Diagnosis can be made with pathology and immunohistochemistry.

关 键 词：神经节瘤 胸部 诊断显像 免疫组织化学 

分 类 号：R734[医药卫生—肿瘤] R445[医药卫生—临床医学]