慢性淋巴水肿相关恶性软组织肿瘤MRI表现  

MRI appearances of malignant soft tissue tumors associated with chronic lymphedema

作　　者：岳云龙[1] 金延方[1] 沈文彬[2] 郭劲松[1] 吴晓华[3] 王振常[3] 

机构地区：[1]首都医科大学附属北京世纪坛医院放射中心,北京100038 [2]首都医科大学附属北京世纪坛医院淋巴外科,北京100038 [3]首都医科大学附属北京友谊医院放射科,北京100050

出　　处：《中国医学影像技术》2014年第4期575-578,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的分析与慢性淋巴水肿相关的软组织恶性肿瘤的MRI表现。方法回顾性分析8例慢性淋巴水肿相关的软组织恶性肿瘤的临床资料及MRI表现。结果病变发生于上臂5例,前臂1例,小腿1例,足部1例。5例血管肉瘤T1WI呈中等信号,T2WI表现为低信号,增强后显著强化。2例原发性皮肤弥漫大B细胞淋巴瘤表现为明显突出于皮肤表面的分叶状等T1稍长T2信号软组织肿块,其内短T2分隔明显强化。1例黏液炎性纤维母细胞肉瘤边缘光滑,T1WI呈稍低信号,T2WI呈高信号。结论慢性淋巴水肿所致局部免疫缺陷可引发多种软组织恶性肿瘤,MRI上其共同特点为皮肤及皮下软组织结节,其中血管肉瘤病灶多发且显著强化有助于与其他肿瘤的鉴别。Objective To observe MRI features of malignant soft tissue tumors associated with chronic lymphedema. Methods MR imaging and clinic data of 8 patients with malignant soft tissue tumors associated with chronic lymphedema were retrospectively analyzed. Results The tumors occurred in upper arm （n = 5）, forearm （n= 1）, leg （n =1） or foot （n= 1）. Angiosarcoma （n= 5） manifested as intermediate signal on T lWI and hypointensity signal on T2WI, with intense and uniform enhancement after administration of contrast media. Primary cutaneous diffuse large B-cell lymphoma （n= 2） showed soft tissue masses protruded from the skin with intermediate signal on TlWI, slight hyperintensity signal on T2WI, and the low signal intensity septum enhanced obviously after administration of contrast media. Myxoinflammatory fibroblastic sarcoma （n= 1） showed slight hypointensity signal on TlWI and hyperintensity signal on T2WI with smooth margins. Conclusion Chronic lymphedema impairs local immune surveillance, which can cause various malignant soft tis- sue tumors, The common character of them on MRI is skin and subcutaneous soft tissue nodules. Multiple foci and obvious enhancement is a special pattern of STS, which is help to differential diagnosis with the other tumors.

关 键 词：Stewart-Treves综合征 肉瘤 软组织肿瘤 磁共振成像 

分 类 号：R738.6[医药卫生—肿瘤] R445.2[医药卫生—临床医学]