膀胱炎性肌纤维母细胞瘤的CT表现  

CT manifestations of inflammatory myfibroblastic tumor of the urinary bladder

作　　者：程强[1] 高剑波[1] 杨学华[2] 阎晓朋 

机构地区：[1]郑州大学第一附属医院放射科,河南郑州450052 [2]郑州人民医院颐和医院

出　　处：《实用放射学杂志》2015年第12期1992-1995,共4页Journal of Practical Radiology

摘　　要：目的 分析膀胱炎性肌纤维母细胞瘤（IMTUB）的CT表现及临床特点，旨在提高诊断正确率。方法 回顾性分析6例经手术或穿刺病理证实的IMTUB的临床资料、CT表现，6例均行CT平扫及增强检查。结果 6例IMTUB均为单发病灶，直径 3.7-7.5 cm，平均（5.2±1.4） cm。病灶位于膀胱后壁3例，膀胱侧壁2例，膀胱顶部1例。CT平扫均呈低密度影。3例呈类圆形，3例呈不规则形。增强扫描动脉期呈中度强化，静脉期呈明显强化，5例呈不均匀强化，1例呈较均匀强化。肿瘤组织学表现为梭形的肌成纤维细胞，以黏液样水肿为背景，伴有许多血管和慢性炎症细胞（淋巴细胞，浆细胞）的浸润。6例免疫组织化学检查结果示间变细胞淋巴瘤激酶（ALK）、平滑肌肌动蛋白（SMA）、波形蛋白（Vimentin）均为强阳性，上皮膜抗原（EMA）、细胞角蛋白（CK）、CD34为部分阳性，S-100为阴性。结论 IMTUB的CT表现与肿瘤内部成分相关，最终确诊仍需依靠病理及免疫组织化学。Objective To improve the diagnosis rate of inflammatory myofibroblastic tumor of the urinary bladder（IMTUB） by analyzing its CT manifestations and clinical features. Methods Clinical and CT manifestations were retrospectively reviewed and analyzed in 6 patients with IMTUB confirmed by surgical pathology or biopsy. All the 6 patients had undergone plain and contrast enhanced CT scan. Results All patients with IMTUB showed a single lesion,of which 3 were round, and the other 3 were irregular, with the diameter ranging from 3.7 cm to 7.5 cm[mean diameter： （5.2±1.4） cm]. Of all the 6 patients,3 were located in posterior wall of the bladder,2 in lateral wall of the bladder,and 1 at the top of the bladder. All lesions showed low density on CT plain scan. After the injection of contrast enhanced medium, lesions showed moderated enhancement in arterial phase, and significantly enhancement in venous phase. Of all the lesions,5 cases showed heterogeneous enhancement and 1 case showed homogeneous enhancement. Histologically,the tumor was composed of numerous spindled myofibroblasts set in a background of myxoid edema with many blood vessels and an infiltrate of chronic inflammatory cells flymphocytes, plasma cells）. Immunohistochemically, the tumor cells were strong positive for ALK,SMA and Vimentin,partial positive for EMA,CK and CD34 and negative for S-100. Conclusion The CT manifestations of IMTUB are associated with the internal structure of the tumor. The final diagnosis relies on pathology and immunohistoehemistry.

关 键 词：膀胱 炎性肌纤维母细胞瘤 计算机体层成像 病理学 

分 类 号：R737.14[医药卫生—肿瘤] R814.42[医药卫生—临床医学]