肝脏神经内分泌癌动态增强CT及病理特点分析

发布时间：2018-02-02 17:09

本文关键词： 肝脏神经内分泌癌体层摄影术 X线计算机动态增强病理免疫组织化学　出处：《临床放射学杂志》2015年11期 　论文类型：期刊论文

【摘要】：目的研究肝脏神经内分泌癌(HNEC)动态增强CT表现及其病理基础。方法回顾性分析8例HNEC患者的临床及CT资料,所有患者均经病理证实,均行四期动态增强CT扫描,即平扫期、动脉期、门静脉期及延时期。总结及归纳CT表现及组织病理学特点。结果 8例患者中1例为左肝单发肿块,7例为肝内多发肿块,大小不等,密度不均,可见不均匀强化或边缘环形强化,门静脉期及延时期强化减低。病理检查显示肿瘤细胞形态多样,可见呈血管样排列的瘤细胞,或排列成片、索、簇样或菊花团样;分化差的癌细胞较小,有分裂像,电镜下有神经内分泌颗粒。免疫组织化学:Cg A及Syn均(+),CEA、HPC及AFP均为(-)。结论动态增强CT对HNEC的诊断有一定的价值,最终确诊依赖病理及免疫组织化学。
[Abstract]:Objective to study the dynamic enhanced CT findings and pathological basis of hepatic neuroendocrine carcinoma (HNEC). Methods the clinical and CT data of 8 patients with HNEC were analyzed retrospectively. Four stages of dynamic enhanced CT scanning were performed, namely, plain scan, arterial phase, portal phase and extension stage. Ct findings and histopathological features were summarized and summarized. In 7 cases, there were multiple masses in the liver with different size, uneven density, uneven enhancement or circular enhancement at the edge, and decreased enhancement in portal vein and extended phase. Pathological examination showed that the tumor cells were diverse in morphology. The tumor cells arranged like blood vessels, or arranged into pieces, cords, clusters or chrysanthemums; The poorly differentiated cancer cells were small with mitotic appearance, and neuroendocrine granules were observed under electron microscope. Conclusion dynamic enhanced CT has a certain value in the diagnosis of HNEC, and the final diagnosis depends on pathology and immunohistochemistry.
【作者单位】：中南大学湘雅二医院放射科;
【基金】：湖南省自然科学基金资助项目(编号14JJ2034)
【分类号】：R735.7;R730.44
【正文快照】： 神经内分泌肿瘤(neuroendocrine tumor,NET)是一类来源于具有分泌功能的神经元和有摄取胺前体脱羧功能细胞的恶性肿瘤,可以发生在全身各个部位,多发生于胃肠道及胰腺,发生在肝脏的较少[1]。文献报道肝脏神经内分泌癌(hepatic neuro-endocrine carcinoma,HNEC)发生率为1.5/10万

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