鼻腔、鼻窦磷酸盐尿性间叶性肿瘤临床及影像学特点  

Clinical and imaging findings of phosphaturic mesenchymal tumor in nasal cavity and paranasal sinus

作　　者：包宏伟[1] 庄奇新[2] 诸晋煜 尚凯 BAO Hongwei;ZHUANG Qixin;ZHU Jinyu;SHANG Kai(Department of Radiology,Shanghai Sizth People's Hospital Jinshan Branch,Shanghai 201599,China;Department of Radiology,Shanghai Sirth People's Hospital,Shanghai 200233,China)

机构地区：[1]上海市第六人民医院金山分院放射科,上海201599 [2]上海市第六人民医院放射科,上海200233

出　　处：《实用放射学杂志》2022年第8期1238-1241,共4页Journal of Practical Radiology

摘　　要：目的探讨鼻腔、鼻窦的磷酸盐尿性间叶性肿瘤(PMT)的临床及影像学特点.方法回顾性分析6例位于鼻腔、鼻窦的P MT的临床、病理、影像学资料,结合文献分析P MT的临床、影像学特征.结果5例临床表现为鼻塞、流涕持续加重,6例全身多处骨痛,3例关节活动受限、部分关节畸形;6例术前血清磷明显低于正常水平、鼻腔肿瘤切除术后2周血清磷恢复正常水平.CT表现为鼻窦鼻部不均匀软组织密度肿块,2例伴有沙砾样钙化,增强扫描肿块呈间隔状强化;MRI T_(1)WI呈等低信号、T_(2)WI抑脂呈高低混杂信号,扩散加权成像(DWI)序列(b值=800 s/mm^(2))呈稍高信号、液体衰减反转恢复(FLAIR)序列呈高信号;增强后病灶呈间隔状强化.结论PMT临床特征以全身性骨痛为主,术前血清磷明显降低、术后血清磷恢复正常.本病肿块组织结构复杂、伴有钙化,MRI信号高低混杂,CT、MRI增强扫描病灶网格状强化为其影像学特征.ObjectiveTo investigate the clinical and imaging features of phosphaturic mesenchymal tumor(PMT)in nasal cavity and paranasal sinus.Methods The clinical,pathological and imaging data of 6 patients diagnosed PMT in nasal cavity and paranasal sinus were analyzed retrospectively.The clinical and imaging findings of PMT were discussed combined with the literatures.Results Clinical performances could be various,including progressive nasal obstruction and runny nose in 5 cases,multiple bone pain in 6 cases,joint activity limits and partial joint deformity in 3 cases.The serum phosphorus level of all patients was significantly lower before operation and returned to normal level 2 weeks after tumor resection.CT findings of the lesions showed inhomogeneous soft tissue density with gravel caleification in 2 cases.The masses were septal enhanced after contrast enhancement.MRI demonstrated lesions with iso-low signal intensity on T_(1)WI,mixed signal intensity on T_(2)WI,slightly high signal intensity on dffusion weighted imaging(DWI)(b value=800 s/mm^(2)),and high signal intensity on fluid attenuated inversion recovery(FLAIR).The masses also appeared septal enhancement after contrast injection.Conclusion The main clinical feature of PMT is systemic bone pain.The serum phosphorus level decreases significantly before operation and returns to normal after resection.The mass has complex tissue structures with calcification and mixed MRI signals.PMT has characteristics in grid enhancement on CT and MRI enhanced scan.

关 键 词：鼻腔 磷酸盐尿性间叶性肿瘤 计算机体层成像 磁共振成像 

分 类 号：R739.62[医药卫生—肿瘤] R814.42[医药卫生—临床医学] R445.2