腺泡状软组织肉瘤的临床及影像学表现  

Alveolar Soft Part Sarcoma: Clinical and Radiological Features

作　　者：赵晓娟[1] 伍尧泮[2] 余深平[3] 陈应明[3] 李智[4] 

机构地区：[1]河南省人民医院超声科,河南郑州450003 [2]中山大学肿瘤防治中心放射科,广东广州510080 [3]中山大学附属第一医院放射科,广东广州510080 [4]中山大学附属第一医院病理科,广东广州510080

出　　处：《中山大学学报（医学科学版）》2013年第5期744-749,共6页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省科技计划项目(2010B08071037)

摘　　要：【目的】总结腺泡状软组织肉瘤(ASPS)的临床病理、磁共振(MRI)及多层螺旋CT(MSCT)特点。【方法】收集经病理证实的27例ASPS的资料,分析其临床病理及影像学特点。【结果】(1)女性11例,男性16例,平均年龄28.7岁。临床表现为无痛性肿块19例;疼痛4例,伴肿瘤远端肢体功能障碍2例;鼻塞、耳鸣1例;体检发现肿物3例。肿瘤平均最大径7.1 cm,位于下肢12例、躯干12例、颌面部3例。(2)术后病理均示瘤细胞呈腺泡状排列,胞浆丰富,内含红染颗粒,核仁明显;糖元染色(PAS)阳性。(3)MRI检查20例:T1WI低信号2例,等信号4例,稍高信号14例;T2WI高信号;6例信号均匀,14例含坏死区。MSCT检查9例:平扫低密度1例,等密度4例,略高及混杂密度各2例;增强扫描肿瘤均明显强化,坏死区无强化;4例瘤内、4例瘤周、19例瘤内和瘤周见大量迂曲血管。骨原发ASPS或ASPS骨转移影像特点与软组织来源者相似。【结论】ASPS为富血供恶性肿瘤,其临床、影像及病理表现具有一定特征性。[ Objective ] To summarize the clinical and pathological, MRI and MSCT features of alveolar soft part sarcoma （ASPS）. [Methods] Thorough clinical pathological and radiographic data of 27 pathological confirmed ASPS patients have been collected and reviewed retrospectively. [ Results ] 11 females and 16 males were admitted in this group. The median age was 28.7 years old. The clinical manifestation was painless mass in 19, painful mass with numb and swelling in 4, distal limb of the tumor dysfunction in 2, nasal congestion and tinnitus in 1, and without symptom in 3. The primary tumor located in lower extremities in 12, trunk in 12, cheek in 3. The median maximum diameter was 7.1 centimeter. The postoperative pathology displayed alveolar arranged tumor cell which has abundant cytoplasm with eosinophilic granular crystallization and prominent nucleolus, and PAS staining were positive. On MRI images of 20 cases, the masses showed 2 slightly hypo, 4 iso- and 14 slightly hyper intensity on Tl-weighted images and high intensity on T2-weighted images, the intensity was homogeneous in 6 and heterogeneous in 14. MSCT was performed in 9 cases, which revealed 1 hypo, 4 iso- and 2 slightly hyper densities, and 2 hypo-iso mixed densities respectively. After contrasted agent injected, all the tumors showed obviously enhancement except necrosis areas. Profuse tortuous vessels distributed in tumors in 4, around them in 4, and both in and around tumors in 19 were detected. The MSCT and MRI features of bony metastatic lesions were similar to the primary tumors. [Conclusion ] ASPS was a kind of rare malignancy with rich blood supply, and there were some characteristics about its clinical, MSCT and MRI features to some degree.

关 键 词：腺泡状软组织肉瘤 磁共振成像 体层摄影术 X线计算机 

分 类 号：R782.13[医药卫生—口腔医学]