小儿睾丸卵黄囊瘤的超声表现特征及其诊断价值  

Ultrasonographic features and diagnostic value of pediatric testicular yolk sac tumor

作　　者：陈洪艳[1] 杨磊[1] Chen Hongyan;Yang Lei(Department of Ultrasound,The First Affiliated Hospital of Kunming Medical University,Kunming 650032,China)

机构地区：[1]昆明医科大学第一附属医院超声科,云南昆明650032

出　　处：《实用肿瘤杂志》2020年第2期181-184,共4页Journal of Practical Oncology

摘　　要：目的分析小儿睾丸卵黄囊瘤的彩色多普勒超声表现。方法收集经病理证实的14例小儿睾丸卵黄囊瘤资料,对其彩色多普勒超声表现进行分析,探讨超声声像图特征及对小儿睾丸卵黄囊瘤的诊断价值。结果超声表现为患侧睾丸呈卵圆形态或不规则形态的团块,病变大小1.2 cm×1.4 cm×1.3 cm^2.6 cm×2.0 cm×1.8 cm;睾丸周围有鞘膜积液;内部回声多样性,包括等回声7例,低回声5例,稍高回声2例;病变周围和内部血流信号丰富。超声诊断为睾丸卵黄囊瘤11例,睾丸间质细胞瘤3例。所有患儿均行腹股沟探查联合睾丸切除术治疗,联合腹膜后淋巴清扫术者4例,术后PEB方案化疗者9例。术后组织标本经病理检查均证实为小儿睾丸卵黄囊瘤,术后约3周血清甲胎蛋白(alpha fetoprotein,AFP)水平为62.2 ng/mL,4周时下降至10.3 ng/mL。重复行胸、腹部和盆腔CT检查,无恶性转移证据。结论若彩色多普勒检查患侧睾丸周围有鞘膜积液,病变周围和内部血流信号丰富,并合并血清AFP水平升高,应考虑卵黄囊瘤可能。Objective To analyze the color Doppler echocardiography of pediatric testicular yolk sac tumor.Methods The data were collected from 14 cases of pediatric testicular yolk sac tumors.The ultrasound findings were analyzed to investigate the characteristics of ultrasound sonography and the diagnostic value of pediatric testicular yolk sac tumor.Results Color Doppler ultrasound showed an oval or irregular mass,and the lesion size was 1.2 cm×1.4 cm×1.3 cm-2.6 cm×2.0 cm×1.8 cm.There was hydrocele around the testis,internal echo diversity,including 7 cases of equal echo,5 cases of hypoechoic,2 cases of slightly hyperechoic.The peripheral and internal blood flow signals are abundant.Ultrasound diagnosed 11 cases of yolk sac tumor and 3 cases of testicular stromal tumor.All the children underwent groin exploration combined with orchiectomy,4 cases were treated with retroperitoneal lymph node dissection,and 9 cases were treated with postoperative chemotherapy.The postoperative tissue samples were all confirmed as pediatric testicular yolk sac tumor by pathological examination.The serum alpha fetoprotein(AFP)level was 62.2 ng/mL at about 3 weeks after the surgery,and decreased to 10.3 ng/mL at 4 weeks after surgery.Repeated CT examinations of the chest,abdomen,and pelvic cavity showed no evidence of malignant metastasis.Conclusions When color Doppler examinations shows hydrocele surrounding the testes,abundant blood flow signals around and inside the lesion,and serum AFP level is elevated,yolk sac tumor should be considered.

关 键 词：睾丸肿瘤/诊断 睾丸肿瘤/治疗 超声检查 多普勒 彩色 甲胎蛋白类 儿童 

分 类 号：R737.21[医药卫生—肿瘤] R730.4[医药卫生—临床医学]