伴有破骨细胞样巨细胞的胰腺未分化癌的影像学特征  

Imaging features of undifferentiated pancreatic carcinoma with osteoclast-like giant cells

作　　者：汪鑫斌 方旭 边云 邱勇刚 董浩 邵成伟 王莉 陆建平 Wang Xinbin;Fang Xu;Bian Yun;Qiu Yonggang;Dong Hao;Shao Chengwei;Wang Li;Lu Jianping(Department of Radiology,First People′s Hospital,Xiaoshan District,Hangzhou 311200,China;Department of Radiology,First Affiliated Hospital of Naval Medical University,Shanghai 200433,China)

机构地区：[1]杭州市萧山区第一人民医院放射科,杭州311200 [2]海军军医大学第一附属医院影像医学科,上海200433

出　　处：《中华胰腺病杂志》2021年第3期173-177,共5页Chinese Journal of Pancreatology

基　　金：国家自然科学基金(81701689、81871352);上海申康医院发展中心重大临床研究项目(SHDC2020CR4073)。

摘　　要：目的探讨伴有破骨细胞样巨细胞的胰腺未分化癌(UCOGCP)的影像学特征。方法回顾性分析2014年12月至2019年1月间海军军医大学第一附属医院收治的4例经病理确诊为UCOGCP患者的CT、MRI影像学资料,记录肿瘤部位、长径、形态、边界、密度或信号、包膜、钙化、出血、囊变、强化程度,以及有无胰管扩张、胰腺实质萎缩,有无周围血管侵犯、淋巴结及器官转移。结果4例UCOGCP中病灶位于胰头部1例,胰体部2例,胰尾部1例。病灶长径3.3~13.0 cm,平均8.8 cm;呈类圆形3例,不规则状1例;边界清晰并见包膜2例,边界模糊2例。4例均为囊实性肿块,其中3例有囊腔分隔。CT平扫示4例肿块均呈不均匀低密度,其中1例有斑点状钙化;增强后肿块实性成分轻度强化,其中2例部分实性成分明显强化。MRI检查示2例T1WI呈混杂低信号,其中1例见小斑片高信号出血灶;T2WI呈混杂高信号,扩散加权成像(DWI)呈弥散受限。2例主胰管扩张,1例胰腺实质萎缩。1例侵犯十二指肠降部,3例周围血管(包括门静脉、脾动脉、脾静脉)受侵,其中1例伴门静脉和脾静脉瘤栓形成,1例伴发胰源性门静脉高压。结论UCOGCP影像学特征为体积较大的囊实性肿块,可伴出血及钙化,增强后实性成分轻度强化,部分实性成分明显强化,分析其影像学特征并结合临床资料,有望提高该疾病诊断准确率。Objective To investigate the imaging features of undifferentiated pancreatic carcinoma(UCOGCP)with osteoclast-like giant cells.Methods CT and MRI data of 4 pathologically diagnosed UCOGCP patients admitted in the First Affiliated Hospital of Naval Medical University from December 2014 to January 2019 were retrospectively analyzed.The tumor location,major length,shape,border,density or signal,capsule,calcification,hemorrhage,cystic degeneration,degree of enhancement,as well as the presence or absence of pancreatic duct dilatation,pancreatic parenchymal atrophy,peripheral vascular invasion,lymph node and organ metastasis were recorded.Results Of 4 UCOGCP patients,1 case had the mass located in head of pancreas,2 cases in body of pancreas,and 1 in tail of pancreas.The length of tumor ranged from 3.3 cm to 13.0 cm,and the average was 8.8 cm.3 cases were round-like,and 1 was irregular;2 tumors were well defined with capsules,2 with unclear border.4 cases showed solid-cystic masses,3 of which had cystic separation.4 cases showed heterogeneous low density on unenhanced CT,and 1 case had spotted calcification.The solid component of the mass was mild enhanced on enhanced CT,and partial solid component of the mass showed obvious enhancement in 2 cases.2 cases showed mixed low signal on T1WI,1 of which had small patchy high signal indicating hemorrhage.2 cases showed mixed high signal on T2WI,and high signal on DWI.2 cases had major pancreatic duct dilation.1 case had pancreatic parenchyma atrophy.1 case had descending duodenum invasion.3 cases had peripheral vascular invasion,including portal vein,splenic artery,and splenic vein.1 case had tumor thrombosis in the portal vein and splenic vein.1 case was associated with pancreatogenous portal hypertension.Conclusions The imaging features of UCOGCP showed a large solid-cystic mass with hemorrhage and calcification.The solid component of the mass was mild enhanced and the partially solid component was obviously enhanced.The combination of its imaging characteristics and clinic

关 键 词：胰腺肿瘤 破骨细胞样巨细胞 体层摄影术 X线计算机 磁共振成像 

分 类 号：R735.9[医药卫生—肿瘤]