儿童肾透明细胞肉瘤的CT增强影像表现特征  

CT-enhanced imaging features of clear cell sarcoma of the kidney in children

作　　者：张晏境 丁建平[1] 陈淑娟 张莉 ZHANG Yanjing;DING Jianping;CHEN Shujuan;ZHANG Li(Department of Radiology,the Affiliated Hospital of Hangzhou Normal University,Hangzhou 310000,China;Department of Radiology,the Children’s Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,Hangzhou 310000,China)

机构地区：[1]杭州师范大学附属医院放射科,浙江杭州310000 [2]浙江大学医学院附属儿童医院放射科国家儿童健康与疾病临床医学研究中心,浙江杭州310000

出　　处：《实用放射学杂志》2023年第5期802-804,共3页Journal of Practical Radiology

摘　　要：目的探讨儿童肾透明细胞肉瘤(CCSK)的CT增强影像学表现。方法回顾性选取经穿刺活检或肾切除术后病理证实的CCSK 14例。治疗前患儿均行全腹部CT增强扫描。结果14例患儿中,肿瘤均单侧发病,起源于肾髓质,呈卵圆形,边界清晰,可见抱球征。瘤体较大,平均(10.0±2.6)cm,推移邻近组织结构。肿瘤跨中线生长8例,分叶状生长12例,钙化5例,出血2例,坏死囊变14例,下腔静脉癌栓形成2例,虎斑条纹征12例,肿瘤树枝状小血管形成12例,淋巴结转移2例。CT增强扫描病灶不均匀、渐进性强化。结论儿童CCSK好发于婴儿期,表现为出血、囊变的较大肿块,实质期虎斑条纹征及皮质期树枝状肿瘤血管充盈较具特征性。早期出现淋巴结及骨转移高度提示CCSK。Objective To explore the CT-enhanced imaging features of clear cell sarcoma of the kidney(CCSK)in children.Methods A total of 14 cases of CCSK confirmed by biopsy or nephrectomy were retrospectively selected.Before treatment,all children underwent CT enhanced scan of the whole abdomen.Results Among the 14 children,the tumors were all unilateral and originated from the renal medulla.The tumors were oval,with clear boundaries and ballhugging signs.The tumor was larger,with an average size of(10.0±2.6)cm,and moved adjacent tissue structures.There were 8 cases of the tumor growing across the midline,12 cases of lobulated growth,5 cases of calcification,2 cases of hemorrhage,14 cases of the necrotic cyst,2 cases of inferior vena cava tumor thrombus,12 cases of tabby sign,and 12 cases of tumor dendritic small blood vessels,2 cases of lymph node metastasis.The lesions were inhomogeneous and progressively enhancement on CT-enhanced scan.Conclusion CCSK is more likely to occur in infancy,and it is characterized by hemorrhage and cystic degeneration.The tabby sign in the parenchyma stage and the dendritic small blood vessels in the cortical stage are more characteristic.Early lymph node and bone metastases are highly suggestive of CCSK.

关 键 词：儿童 肾脏 透明细胞肉瘤 计算机体层成像 

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