脾脏炎性假瘤样滤泡树突细胞肉瘤CT表现特征  

CT features of inflammatory pseudotumor like follicular dendritic cell sarcoma of the spleen

作　　者：谢品楠 胡明哲 孙厚长[3] 邵庆洪 邱乾德 Xie Pinnan;Hu Mingzhe;Sun Houzhang;Shao Qinghong;Qiu Qiande(Department of Radiology,Yongjia People's Hospital of Zhejiang,Yongjia 325100,China;Department of Imaging,Wenzhou People's Hospital of Zhejiang,Wenzhou 325000,China;Department of Radiology,First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China;Department of Pathology,Yongjia People's Hospital of Zhejiang,Yongjia 325100,China)

机构地区：[1]浙江省永嘉县人民医院放射科,永嘉325100 [2]浙江省温州市人民医院影像科,温州325000 [3]温州医科大学附属第一医院放射科,温州325000 [4]浙江省永嘉县人民医院病理科,永嘉325100

出　　处：《中华肝胆外科杂志》2023年第8期605-608,共4页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的探讨脾脏炎性假瘤样滤泡树突状细胞肉瘤(FDCS)的CT表现特征。方法回顾性分析2015年1月至2022年12月浙江省永嘉县人民医院、温州市人民医院和温州医科大学附属第一医院收治的12例脾脏炎性假瘤样FDCS患者临床资料,其中男性4例,女性8例,中位年龄60岁,年龄范围41~80岁。通过患者CT影像资料分析病灶数量、形态、大小和CT表现特征等指标。结果12例患者的CT显示15个病灶,其中单发10例,多发2例;病灶呈圆形5例,椭圆形4例,不规则形3例;肿块最大径中位数6.5 cm。CT平扫见12例肿瘤均呈低密度或略低密度;CT值为(41.3±7.2)HU;密度不均匀8例,均匀4例;肿瘤界限清楚8例,不清楚4例;肿瘤坏死囊变8例,肿瘤中心见条片状出血灶5例。CT增强见12例于动脉期显示肿瘤边缘或实质部分呈小片状或絮状强化,CT值为(56.0±3.8)HU;其中轻度强化7例,中度强化4例,显著强化1例;门静脉期呈轻、中度持续性小片状不均匀强化,CT值为(62.0±4.3)HU,其中轻度强化8例,中度强化4例;延迟期见强化缓慢退出,CT值为(45.0±8.2)HU。12例患者均行病灶完整切除术,经病理学检测确诊为FDCS。结论FDCS在CT平扫中显示圆形或椭圆形不均匀低密度肿块,增强动脉期呈小片状或絮状轻、中度不均匀强化,门静脉期持续强化,延迟期缓慢以退出为主要特征。Objective To explore the CT features of inflammatory pseudotumor like follicular dendritic cell sarcoma(FDCS)of the spleen.Methods The clinical data of 12 patients with splenic inflammatory pseudotumor like FDCS admitted to 3 central hospitals including Yongjia People's Hospital in Zhejiang Province from January 2015 to December 2022 were retrospectively analyzed,including 4 males and 8 females,with a median age of 60 years old.The number,shape,size and CT features of the lesions were analyzed based on patient's CT image data.Results CT scans of 12 patients showed 15 lesions,including 10 single lesions and 2 multiple lesions.The lesions were circular in 5 cases,elliptical in 4 cases,and irregular in 3 cases.The median maximum diameter of the mass is 6.5 cm.On plain scan,all 12 tumors showed low density or slightly low density.The CT value is(41.3±7.2)HU;8 cases had uneven density and 4 cases had uniform density.There were 8 cases with clear tumor boundaries and 4 cases with unclear boundaries.There were 8 cases with tumor necrosis and cystic transformation,and 5 cases showed patchy bleeding lesions in the center of the tumor.Enhancement:the arterial phase shows small patches or flocculent enhancement at the edges or parenchymal parts of the tumor,with CT value of(56.0±3.8)HU.Among them,there were 7 cases of mild enhancement,4 cases of moderate enhancement,and 1 case of significant enhancement.During the portal phase,there was mild to moderate persistent small patchy uneven enhancement,with CT value of(62.0±4.3)HU.Among them,there were 8 cases of mild enhancement and 4 cases of moderate enhancement.The delayed phase showed a slow withdrawal of enhancement,with CT value of(45.0±8.2)HU.All 12 cases underwent complete resection and were diagnosed with FDCS through pathological examination.Conclusion FDCS plain scan shows circular or elliptical uneven low-density masses,with small patches or flocculent light to moderate uneven enhancement in the arterial phase,continuous enhancement in the portal phase,and slow wi

关 键 词：脾肿瘤 炎性假瘤样 滤泡树突状细胞肉瘤 体层摄影术 X线计算机 

分 类 号：R733.2[医药卫生—肿瘤]