胰腺罕少见恶性肿瘤CT表现及文献回顾  

Rare malignant pancreatic neoplasms:CT findings and literature review

作　　者：杨惠君 郝金钢[1] YANG Huijun;HAO Jingang(Department of Radiology,the Second Affiliated Hospital of Kunming Medical Universit y,Kunming 650101,China)

机构地区：[1]昆明医科大学第二附属医院放射科,云南昆明650101

出　　处：《实用放射学杂志》2021年第5期790-793,共4页Journal of Practical Radiology

基　　金：昆明医科大学研究生创新基金项目(2020S195).

摘　　要：目的探讨胰腺罕少见恶性肿瘤的CT影像表现.方法回顾性分析12例胰腺罕少见恶性肿瘤患者的CT检查资料,并复习文献.结果12例胰腺罕少见恶性肿瘤的男女比例为7︰5,以中老年患者多见,其中淋巴瘤3例,腺鳞癌2例,鳞癌2例,转移瘤2例,黏液性囊性肿瘤相关浸润性癌1例,孤立性纤维性肿瘤1例,肝样癌1例.肿瘤呈实性或囊实性的稍低或等密度影,边界清楚或不清楚,常伴有胰管扩张,增强扫描实性成分呈轻中度或明显强化,部分肿瘤可见延迟强化的包膜,部分肿瘤侵犯周围组织,伴有腹膜后淋巴结肿大.结论胰腺罕少见恶性肿瘤的CT影像表现具有一定的特征.乏血供肿瘤有淋巴瘤和腺鳞癌,后者易囊变.富血供肿瘤中,鳞癌易坏死;黏液性囊性肿瘤相关浸润性癌为囊实性,囊壁厚薄不均;孤立性纤维性肿瘤和肝样癌强化常表现为“快进快出”样强化方式,前者常有包膜,后者甲胎蛋白升高.转移瘤的血供常与原发病灶一致.OhjectiveTo investigate the CT findings of rare malignant pancreatic neoplasms.MethodsThe CT findings of 12 patients with rare malignant pancreatic neoplasms were analyzed retrospectively and the literature was reviewed.Results The gender ratio of 12 cases of rare malignant pancreatic neoplasms was 7:5,and the most of them were middle-aged or elderly,including 3 cases of lymphoma,2 cases of adenosquamous carcinoma,2 cases of squamous cell arcinoma,2 cases of metastatic tumor,1 case of mucinous cystic neoplasm related invasive carcinoma,1 case of solitary fibrous tumor and l case of hepatoid adenocarcinoma.The tumors were mostly solid or cystic solid,showing slightly hypo-or iso-density,with well-defined margin or not,and the pancreatic duct was commonly dilated.The solid components were mild to moderate or significant enhanced.Some were capsuled with delayed enhancement.Ssome invaded surrounding tissue.The aggressive retroperitoneal lymph nodes enlargement were commonly seen.ConclusionThere are some certain characteristics CT imaging features among the rare malignant pancreatic neoplasms.Poor blood supply neoplasms includes lymphoma and adenosquamous carcinoma,and the latter one is prone to cystic change.In the abundant blood supply neoplasms,the squamous cell carcinoma is prone to nccrosis,the mucinous cystic neoplasms related invasive carcinoma is cystic solid with the uneven wall thickness,and the enhancement of solitary fibrous tumor and hepatoid adenocarcinoma are both“washing-in and washing-out”pattern.The forner one is capsuled,while the latter one shows increased alpha fetoprotein.The blood supply of metastatic tumor is similar to the primary lesions.

关 键 词：胰腺 恶性肿瘤 计算机体层成像 

分 类 号：R735.9[医药卫生—肿瘤] R814.42[医药卫生—临床医学]