促结缔组织增生性小圆细胞肿瘤的CT特征及鉴别诊断  

CT features and differential diagnosis of desmoplastic small round cell tumors

作　　者：房泽辉[1] 戚元刚[2] 王冰[3] FANG Ze-hui;QI Yuan-gang;WANG Bing(Department of Radiology,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,China)

机构地区：[1]山东中医药大学附属医院影像科,济南250014 [2]山东第一医科大学附属肿瘤医院(山东省肿瘤医院),济南250117 [3]山东第一医科大学第三附属医院(山东省医学科学院附属医院)放射科,济南250031

出　　处：《放射学实践》2022年第5期571-573,共3页Radiologic Practice

基　　金：山东省医药卫生科技发展计划项目(2019ws200)。

摘　　要：目的:总结分析促结缔组织增生性小圆细胞肿瘤(DSRCT)的特征性CT表现,提高鉴别诊断能力。方法:回顾性分析经病理证实的14例DSRCT患者的临床及CT表现,总结病变CT特点(肿块位置、密度、强化特点,腹膜、腹水及脏器受侵等)。结果:14例DSRCT患者中,男11例(78.5%),女3例(21.4%),年龄9~42岁,平均(21.1±29.8)岁。肿块位于盆腔(膀胱后方)者12例(85.7%);增强扫描14例(100%)肿块均呈持续强化;腹膜增厚者14例(100%),其中结节样、肿块样增厚10例(71.4%),絮状、饼状增厚9例(64.3%);10例(71.4%)合并少量腹水;8例(57.1%)发生腹腔腹膜后淋巴结转移,共10例(71.4%)发生远处转移(肝、肺、骨转移)。结论:DSRCT好发于青年男性,盆腔肿块并持续强化、少量腹水、腹膜增厚为其特征性CT表现,可与淋巴瘤腹膜侵犯、腹膜转移等相鉴别。Objective:To summarize the CT characteristics of desmoplastic small round cell tumor(DSRCT)and improve the differential diagnostic ability.Methods:The clinical data and dynamic enhanced CT images of 14 patients with DSRCT confirmed by pathology were retrospectively analyzed,and the CT features(mass location,density,enhancement characteristics,peritoneum,ascites and viscera invasion,etc)were summarized.Results:Among the 14 patients with DSRCT,there were 11 males(78.5%)and 3 females(21.4%),aged 9~42 years old,with an average age of(21.1±29.8 years old).12 cases(85.7%)had mass in pelvic cavity(posterior to bladder).Dynamic contrast-enhanced scan showed continuous enhancement in 14 cases(100%).Peritoneal thickening was observed in 14 cases(100%),including nodule and mass-like thickening in 10 cases(71.4%),flocculent and cake-like thickening in 9 cases(64.2%).10 patients(71.4%)had a small amount of ascites.There were 8 cases(57.1%)presented peritoneal retroperitoneal lymph node metastasis,and 10 cases(71.4%)had distant metastasis(liver,lung,bone).Conclusion:DSRCT is more common seen in young men.Pelvic mass,continuous enhancement and a small amount of ascites are typical CT features,which can be used to distinguish from lymphoma with peritoneal invasion,peritoneal metastasis,etc.

关 键 词：促结缔组织增生性小圆细胞肿瘤 软组织肿瘤 体层摄影术 X线计算机 诊断 鉴别 病理学 

分 类 号：R738.6[医药卫生—肿瘤] R814.42[医药卫生—临床医学]