纵隔原发性室管膜瘤误诊分析  

Misdiagnosis of Primary Ependymoma of Mediastinum

作　　者：朱静 郝胜璞 张正楠 周金丽 杨海庆[1] ZHU Jing;HAO Shengpu;ZHANG Zhengnan;ZHOU Jinli;YANG Haiqing(Department of Radiology,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院放射科,石家庄050000

出　　处：《临床误诊误治》2024年第1期16-18,共3页Clinical Misdiagnosis & Mistherapy

摘　　要：目的分析纵隔原发性室管膜瘤的误诊原因。方法回顾性分析2023年7月收治的1例纵隔原发性室管膜瘤的临床资料及影像学表现。结果患者体检发现后纵隔无痛性肿物,实验室检查未见明显异常;胸部CT示后纵隔囊性肿物,考虑神经源性可能性大;纵隔囊肿穿刺活检后病理涂片倾向于胸腺来源囊肿,患者住院后行右侧胸腔镜下纵隔囊肿切除术,术后病理诊断为纵隔原发性室管膜瘤。随访未见复发和并发症。结论纵隔原发性室管膜瘤发病极为罕见,易误诊为胸腺或神经来源囊肿,临床及影像科医师遇到此部位病变应考虑到该病可能,确诊需结合病理学免疫组化检查。Objective To analyze the causes of misdiagnosis of primary mediastinal ependymoma(PME).Methods The clinical data and imaging manifestations of a patient with PME treated in July 2023 were retrospectively analyzed.Results In this patient,a painless mass was found in the mediastinum during physical examination,with no significant abnormalities observed in laboratory tests.Chest CT showed posterior mediastinal cystic mass,considering the possibility of neurogenic disease.Pathological smears after puncture biopsy of mediastinal cysts tended to be cysts of thymus origin.The patient underwent right thoracoscopic mediastinal cyst resection after admission,and the postoperative pathological diagnosis revealed PME.No recurrence or complications were observed during follow-up.Conclusion The occurrence of PME is extremely rare,which is more likely to be misdiagnosed as cysts of thymus or nerve origin.Clinical and imaging physicians should consider the possibility of this disease when they encounter lesions at this site,and the diagnosis should be combined with pathological and immunohistochemical examination.

关 键 词：室管膜瘤 误诊 纵隔囊肿 病理学 体层摄影术 螺旋计算机 GFAP PAX-8 VIMENTIN 

分 类 号：R730.264[医药卫生—肿瘤]