MiT家族易位性肾细胞癌的影像学表现及临床病理对照  

MiT family translocation renal cell carcinoma:imaging manifestations and clinical pathology

作　　者：翟晶晶 肖渤瀚[1] 孙琳[2] 叶兆祥[1] ZHAI Jingjing;XIAO Bohan;SUN Lin;YE Zhaoxiang(Department of Radiology,Tianjin Medical University Cancer Institute and Hospital,Tianjin 300060,China;Department of Pathology,Tianjin Medical University Cancer Institute and Hospital,Tianjin 300060,China)

机构地区：[1]天津医科大学肿瘤医院放射科,天津300060 [2]天津医科大学肿瘤医院病理科,天津300060

出　　处：《实用放射学杂志》2021年第7期1131-1135,共5页Journal of Practical Radiology

摘　　要：目的 探讨MiT家族易位性肾细胞癌(RCC)的CT、MRI影像特征.方法 回顾性分析经病理证实的28例MiT家族易位性RCC的CT、MRI表现及临床病理资料,包括26例Xp11.2易位/TFE3基因融合相关性肾细胞癌(Xp11.2 RCC)和2例t(6;11)(p21;q12)/TFEB基因融合相关性肾细胞癌[t(6;11)RCC].20例Xp11.2 RCC和2例t(6;11)RCC行CT检查,6例Xp11.2 RCC行MRI检查.结果 26例Xp11.2 RCC病灶最大径1.8~16.5 cm,平均(5.7±3.8)cm;圆形或类圆形19例,形态不规则7例;囊实性17例,实性9例;1例伴肾静脉瘤栓,1例伴肺转移,4例伴腹膜后淋巴结转移(1例同时伴肝、肺转移).20例Xp11.2 RCC病灶CT平扫图像中,实性部分呈稍高密度13例,等密度7例,7例伴钙化;6例Xp11.2 RCC病灶MRI平扫图像中,5例实性部分呈T_(1)WI等-稍高信号、T_(2)WI稍低信号,1例呈T_(1)WI等-稍低信号、T_(2)WI等-稍高信号;CT和MRI增强扫描共21例呈持续性轻度至中度强化,5例呈"快进慢退".2例t(6;11)RCC病灶最大径6.2 cm、3.1 cm,均呈类圆形、囊实性,CT平扫实性部分呈稍高密度,增强扫描1例"渐进性强化",1例皮质期中度强化、实质期及延迟期强化逐渐减退.结论 MiT家族易位性RCC中,Xp11.2 RCC影像表现有一定特点,当瘤体较大、呈囊实性、伴有钙化、实性部分CT平扫呈稍高密度、T_(2)WI呈稍低信号、增强扫描持续性轻度至中度强化时,应考虑到此病的可能;t(6;11)RCC罕见,缺乏明确的影像特征.Objective To investigate the CT and MRI features of MiT family translocation renal cell carcinoma(RCC).Methods CT or MRI features,clinical and pathological data of 28 patients with MiT family translocation RCC confirmed by pathology were analyzed retrospectively,including 26 cases of Xp11.2 RCC and 2 cases of t(6;11)RCC.20 cases of Xp11.2 RCC and 2 cases of t(6;11)RCC underwent CT examination,and 6 cases of Xp11.2 RCC underwent MRI examination.Results The maximum diameter of 26 Xp11.2 RCC lesions ranged from 1.8 cm to 16.5 cm,with average diameter of(5.7d±3.8)cm;19 tumors were round or class round,7 tumors were irregular;17 tumors were cystic-solid,9 tumors were solid;1 case had tumor thrombus in renal vein,l case had pulmonary metastasis,4 cases had retroperitoneal lymph nodes metastases(1 case both had pulmonary and hepatic metastases).On plain CT images of 20 Xp11.2 RCC tumors,the solid part of 13 lesions presented slightly high density and of 7 lesions presented isodensity.Calcification was seen in 7 cases.On plain MRI images of 6 Xp11.2 RCC tumors,the solid part of 5 lesions showed iso-slightly higher signal on T_(1)WI and slightly lower signal on T_(2)WI,of 1 lesion showed iso-slightly lower signal on T_(1)WI and iso-slightly higher signal on T_(2)WI.A total of 21 lesions presented continuous mild to moderate enhancement in CT and MRI contrast-enhanced scans,5 lesions enhanced significantly in early phases and the enhancement degree reduced slowly.The maximum diameters of the 2 cases of t(6;11)RCC were 6.2 cm and 3.1 cm,both were round and cystic-solid,and the solid part were slightly high density on plain CT images.1 lesion showed progressive enhancement,the other showed moderate enhancement in corticomedullary phase and the enhancement degree reduced gradually in nephrographic and delayed phase.Conclusion In MiT family translocation RCC,Xp11.2 RCC has some characteristic findings on CT and MRI images.This disease should be considered when a renal tumor is large,cystic-solid,combined with calcification,th

关 键 词：MiT家族 易位 肾细胞癌 计算机体层成像 磁共振成像 

分 类 号：R737.11[医药卫生—肿瘤] R814.42[医药卫生—临床医学]