肾脏尤文肉瘤/原始神经外胚层肿瘤CT表现与病理分析  

CT Findings and Pathological Analysis of Ewing’s Sarcoma/Primitive Neuroectodermal Tumor of the Kidney

作　　者：刘显旺 李颖 郝艳[2] 刘宏[1,3] 魏晋艳 史爱琪 王国娟 王建林 周俊林 LIU Xianwang;LI Ying;HAO Yan(Department of Radiology,Lanzhou University Second Hospital,Lanzhou,Gansu Province 730030,P.R.China)

机构地区：[1]兰州大学第二医院放射科,甘肃省医学影像重点实验室,730030 [2]兰州大学第二医院病理科,730030 [3]甘州大学第二临床医学院,730030 [4]皖南医学院弋矶山医院影像中心,芜湖241001

出　　处：《临床放射学杂志》2021年第10期1974-1977,共4页Journal of Clinical Radiology

基　　金：国家自然科学基金资助项目(编号:81772006);兰州大学“中央高校基本科研业务费专项资金”重点研究基地建设项目资助项目(编号:lzujbky-2021-kb32)。

摘　　要：目的探讨肾脏尤文肉瘤/原始神经外胚层肿瘤(ES/PNET)的CT表现及病理特征,旨在提高对该病的认识。方法回顾性分析经手术病理证实的7例肾脏ES/PNET患者的临床资料,并结合文献分析其CT表现及病理特征。结果7例肾脏ES/PNET中,男3例,女4例,年龄20~49岁,平均(29.57±11.86)岁;肿瘤均为单发,左肾4例,右肾3例,肿瘤形态不规则者4例,规则者3例,边界不清晰者4例,清晰者3例,2例瘤体内伴有出血,7例肿瘤内均出现不同程度的坏死囊变,增强扫描后肿瘤呈不均匀轻-中度渐进性强化;2例患者术后出现转移,1例出现复发。所有肿瘤免疫组织化学染色CD99均呈弥漫性阳性表达。结论年轻患者发现肾实质内单发、体积较大、形态不规则、密度不均匀,与周围组织分界不清,增强后呈不均匀轻-中度渐进性强化的软组织肿块时,应考虑到肾脏ES/PNET可能,但最终确诊需依靠病理检查。Objective To investigate the CT findings and pathological features of Ewing’s sarcoma/primitive neuroectodermal tumor(ES/PNET)of the kidney,in order to improve the understanding of the disease.Methods The clinical data of 7 patients with renal ES/PNET confirmed by operation and pathology were analyzed retrospectively,and their CT manifestations and pathological features were analyzed in combination with the literature.Results Among the 7 cases of renal ES/PNET,there were 3 males and 4 females,aged from 20 to 49 years old,with an average age of 29.57±11.86 years.The tumors were all solitary,left kidney in 4 cases,right kidney in 3 cases,irregular shape in 4 cases,regular in 3 cases,unclear boundary in 4 cases,clear in 3 cases,hemorrhage in 2 cases,necrotic cyst in 7 cases,inhomogeneous mild-moderate progressive enhancement after enhanced scan,metastasis in 2 cases and recurrence in 1 case.All tumor immunohistochemical staining showed diffuse positive expression of CD99.Conclusion When young patients find single soft tissue lesion in the renal parenchyma,with large volume,irregular shape,uneven density,unclear boundary and inhomogeneous mild-moderate progressive enhancement after enhancement.The diagnosis of renal ES/PNET should be considered,although the golden-standard diagnosis depends on pathological examination.

关 键 词：肾肿瘤 尤文肉瘤/原始神经外胚层肿瘤 体层摄影术 X线计算机 

分 类 号：R735.7[医药卫生—肿瘤]