胰头部原发恶性周围神经鞘膜瘤1例:CT影像表现及病理分析  

A case of primary malignant perineural sheath tumor in the head of the pancreas:CT imaging features and pathological analysis

作　　者：曾燕妮 彭剑峰[1] 宋亭[2] ZENG Yanni;PENG Jianfeng;SONG Ting(Department of Radiology,Huadu District People’s Hospital,Guangzhou 510800,China;Department of Radiology,The Third Affiliated Hospital of Guangzhou Medical University)

机构地区：[1]广州市花都区人民医院放射科,广州510800 [2]广州医科大学附属第三医院放射科

出　　处：《国际医学放射学杂志》2023年第4期473-475,共3页International Journal of Medical Radiology

摘　　要：目的探讨胰头部原发性恶性周围神经鞘膜瘤(MPNST)的多层螺旋CT(MSCT)影像及病理学表现,以提高对MPNST的认识。方法回顾性分析1例胰头部原发性MPNST病人在19个月内的5次MSCT的影像变化及病理表现。结果病人首次CT检查发现胰头部一个环形强化结节灶。此后病人进行4次CT检查,动脉期均呈环形强化,与胰腺组织强化程度相当或更高;门静脉期、延迟期低强化区域逐渐增大。末次CT可见肿物呈分叶状并长入十二指肠肠腔内。肿瘤呈进展性增长,倍增时间为98.3d。病理显示肿物大小5cm×5cm×4cm,肿瘤局部侵犯胰腺组织,伴有坏死。免疫组化上S-100、Vimentin、CD99、Bcl2、Ki-67、CK7、CK20、EMA均为阳性。结论MPNST的MSCT表现与病理成分相关,MSCT检查有利于认识MPNST的特征及准确定位,并可识别邻近结构是否受侵。Objective To analyze the multispiral CT(MSCT)imaging features and pathological findings of a primary malignant peripheral nerve sheath tumor(MPNST)in the pancreatic head,aiming to enhance understanding of this tumor.Methods We conducted a retrospective analysis of the MSCT imaging changes observed in a series of five CT exams over a period of 19 months,along with the pathology results,in a patient diagnosed with a primary MPNST in the pancreatic head.Results During the patient’s initial CT examination,a ring-enhancing lesion was discovered in the pancreatic head.Subsequently,the patient underwent four additional CT examinations,during which the arterial phase consistently demonstrated ring enhancement,equal to or greater than the enhancement of the surrounding pancreatic tissue.In the portal and delayed phases,the area of low enhancement gradually increased.In the most recent CT scan,the mass appeared lobulated and extended into the lumen of the duodenum.The tumor exhibited progressive growth,with a doubling time of 98.3 days.Pathological examination confirmed a tumor size of 5 cm×5 cm×4 cm,along with local invasion into the pancreatic tissue and necrosis.Immunohistochemical analysis showed positive expression of S-100,Vimentin,CD99,Bcl2,Ki-67,CK7,CK20,and EMA.Conclusions The MSCT findings of MPNST demonstrate a correlation with the tumor’s pathological characteristics.Additionally,these findings contribute to a better understanding of the tumor’s features,accurate localization,and identification of adjacent structure invasion.

关 键 词：胰腺 恶性周围神经鞘膜瘤 体层摄影术 X线计算机 病理学 

分 类 号：R816.5[医药卫生—放射医学]