涎腺腺泡细胞癌的超声表现及病理对照分析  

Ultrasound features of acinic cell carcinoma in the salivary gland

作　　者：贾春岩[1] 李月河 Jia Chunyan;Li Yuehe(Departmentof Ultrasound,Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China;Department of Imaging,Fengcheng Hospital of Fengxian District,Shanghai 20141l,China)

机构地区：[1]上海中医药大学附属市中医医院超声科,200071 [2]上海市奉贤区奉城医院影像科,201411

出　　处：《中华医学超声杂志（电子版）》2023年第4期462-466,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨涎腺腺泡细胞癌(ACC)的超声声像图表现,对照分析其相应的病理学基础。方法回顾性选取2003年7月至2019年11月于上海中医药大学附属市中医医院和上海市奉贤区奉城医院经手术病理证实为ACC的患者39例。所有患者术前均进行涎腺超声检查,对肿瘤边界、内部回声、形态、后方回声、囊实性等超声表现进行总结;同时将超声声像图与病理资料作对照分析。结果本组ACC发生于腮腺(含副腮腺)37例(94.9%),2例发生于颌下腺。声像图多数表现为边界清晰(28/39,71.8%),病理对照提示33例(33/39,84.6%)肿瘤有包膜,但包膜多不完整;形态以椭圆形、分叶状较多见(33/39,84.6%);病变以低回声(24/39,61.5%)、混合性回声(14/39,35.9%)为主,多数内部回声不均(25/39,64.1%),82.1%(32/39)的肿块后方回声增强,病理对照示27例(27/39,69.2%)细胞间隙内见大量似胶冻样PAS阳性物质;血流信号不丰富20例(20/39,51.3%),病理对照示肿瘤血管密度稀疏者18例(18/39,46.2%)。结论ACC具有一定的超声表现特征及相应的病理学基础,但其恶性特征不具有典型性,因此超声定性诊断存在一定局限性,诊断准确性有待进一步提高。Objective To explore the ultrasonographic features of salivary acinic cell carcinoma(ACC)and analyze the corresponding pathological basis.Methods Thirty-nine patients with acinic cell carcinoma between July 2003 and November 2019 confirmed by surgery and pathology at Shanghai Municipal Hospital of Traditional Chinese Medicine and Fengcheng Hospital of Fengxian District were retrospectively analyzed.Ultrasonographic features,including the boundary,internal echo,morphology,posterior echo,and cystic and/or solid mixed echo,were summarized.The pathological data and the sonographic images were comparative analyzed.Results There were 37 cases(94.9%)occurring in the parotid gland and 2 cases in the submandibular gland.Most of the lesions were showed a clear boundary(28/39,71.8%).Pathology showed that the tumors had envelopes in 33 cases(33/3984.6%),the envelopes were incomplete,and oval and lobular morphology was common(33/39,84.6%).The majority of lesions had hypoechoic(24/3961.5%)and mixed echo(14/39,35.9%),the internal echo was heterogeneous(25/39,64.1%),and echo enhancement occurred behind most masses(32/39,82.1%).Pathological analysis suggested that 27 cases(27/3969.2%)had a large amount of jelly-like PAS positive substances in the intercellular space.Color Doppler flow imaging(CDFI)signal was not abundant in 20 cases(20/39,51.3%).Pathology showed that tumor vascular density was sparse in 18 cases(18/3946.2%).Conclusion ACC has some ultrasonographic features and corresponding pathological basis,but its malignant signs are not typical,so the qualitative diagnosis of ACC by ultrasonography has some limitations,and the diagnostic accuracy needs to be further improved.

关 键 词：超声检查 涎腺 腺泡细胞癌 病理学 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.31[医药卫生—诊断学]