阑尾低级别黏液性肿瘤的CT表现及病理特征  

CT manifestations and pathological features of low-grade appendiceal mucinous neoplasms

作　　者：刘一铭 印隆林 印培源[3] 吴颖 曹新玥[2] 孙菊 LIU Yiming;YIN Longlin;YIN Peiyuan;WU Ying;CAO Xinyue;SUN Ju(Department of Radiology,Affiliated Hospital of Southwest Medical University,Luzhou,Sichuan 646000,P.R.China;Department of Radiology,Sichuan Academy of Medical Sciences&Sichuan Provincial People’s Hospital,Chengdu 610072,P.R.China;Clinical Medical College,Chengdu Medical College,Chengdu 610500,P.R.China)

机构地区：[1]西南医科大学附属医院放射科,四川泸州646000 [2]四川省医学科学院·四川省人民医院放射科,成都610072 [3]成都医学院临床医学院,成都610500

出　　处：《中国普外基础与临床杂志》2021年第11期1499-1503,共5页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的总结阑尾低级别黏液性肿瘤(low-grade appendiceal mucinous neoplasm,LAMN)的CT影像学特征及其病理特征。方法回顾性分析2018年1月至2020年12月期间在四川省医学科学院·四川省人民医院行CT检查,并于CT检查完成后1个月内经手术病理检查证实为LAMN的24例患者的临床及CT影像学资料,重点观察肿瘤在CT影像上的位置、形态学特征、囊壁及内部特征、囊内密度及肿瘤强化特征。结果①肿瘤位置:24例LAMN中,20例位于右下腹阑尾区、2例位于右中腹、2例位于盆腔。②肿瘤形态学特征:15例呈管状,3例呈椭圆形,5例呈囊袋状,1例呈不规则形。24例肿瘤的长径平均为6.4 cm(4.2~12.0 cm),短径平均为2.2 cm(0.8~5.0 cm),其中17例短径超过1.5 cm。③囊壁及内部特征:24例肿瘤均呈囊性,6例壁薄且均匀光整,18例囊壁厚薄不均,8例囊壁见弧线状、点状或蛋壳样钙化。④囊内密度及肿瘤强化特征:CT平扫时22例囊液呈均匀低密度(CT值7~25 HU),2例密度不均含少许稍高密度影;16例行增强扫描者中8例未见明显强化,8例囊壁、分隔或壁结节轻度或中度强化。⑤病理结果:大体标本中15例阑尾呈管状扩张,9例阑尾部分或全部膨胀呈囊状,24例病灶内容物呈胶冻样或黏液样。镜下所有病灶均见低级别黏液上皮增生,黏膜下层及黏膜肌层萎缩、伴纤维化或钙化。结论LAMN的CT表现具有一定的特征,认识这些特征有助于提高术前CT检查诊断的准确性。Objective To conclude the CT manifestations and pathological features of low-grade appendiceal mucinous neoplasms.Methods We reviewed the clinical and CT findings of 24 patients with low-grade appendiceal mucinous neoplasms,who were confirmed by pathology within 1 month after CT examination in Sichuan Provincial People’s Hospital from January 2018 to December 2020.The distribution,morphological characteristics,cyst wall and internal characteristics,CT value and enhancement characteristics of tumors were be detected in detail.Results①Distribution:of the 24 patients,22 patients located in the appendix area of the right lower quadrant,2 patients located in the right middle abdomen,and 2 patients located in the pelvic cavity.②Morphological characteristics:of the 24 patients,15 patients manifested as tubular,3 patients manifested as ellipsoidal,5 patients manifested as saccular,and 1 patient manifested as irregular shape.The average length of tumors was about 6.4 cm(4.2–12.0 cm),and the average short diameter of tumors was about 2.2 cm(0.8–5.0 cm).The short diameter of 17 patients were more than 1.5 cm.③The cyst wall and internal characteristics:all the 24 patients demonstrated as cystic mass,6 patients had evenly thin and smooth cyst wall,and other 18 patients had uneven cyst wall.Of all the patients,8 patients had arc-shaped,punctate or eggshell-like calcification.④The CT value and enhancement characteristics:24 patients examined by plain CT scan,22 patients showed uniform low density(the CT value were 7–25 HU),2 patients contained some slightly high density,16 patients examined by enhanced CT,the cyst wall,separation,or mural nodules of 8 patients were slightly or moderately enhanced.⑤Pathological results:of all the gross specimens,15 patients showed tubular dilation,9 patients showed partial or complete dilation as cystic mass.All the 24 patients had gelatinous or mucinous contents.Microscopically,all the patients showed low-grade mucinous epithelial hyperplasia,submucosa,and mucosal muscle atrop

关 键 词：阑尾低级别黏液性肿瘤 CT检查 病理特征 诊断 鉴别诊断 

分 类 号：R735.36[医药卫生—肿瘤]