原发性性腺外内胚窦瘤的影像诊断与病理分析

发布时间：2018-03-17 18:22

本文选题：内胚窦瘤　切入点：性腺外　出处：《临床放射学杂志》2017年09期 　论文类型：期刊论文

【摘要】：目的探讨原发性性腺外内胚窦瘤(EST)的影像学特征及其病理基础,提高对该肿瘤的认识。方法回顾性分析17例经病理证实的原发性性腺外EST的临床及影像学资料,总结其临床、CT及MRI特征,并与手术病理结果进行对照分析。结果肿瘤位于前纵隔5例,腹膜后1例,骶尾部8例,颅脑3例。男7例,女10例。CT及MRI表现为巨大软组织肿块,呈圆形、椭圆形或不规则形,密度及信号不均匀,13例为实性肿块,4例为囊实性肿块;增强扫描实性部分呈中度-高度强化,囊性部分无强化,10例瘤体内可见走行迂曲的线状或条状血管影。17例行血清学检查血清甲胎蛋白(AFP)明显升高。病理学表现为肿瘤组织形态多样,间质排列成疏松的网状结构,其内可见S-D小体,嗜酸性小体。结论原发性性腺外EST影像表现具有一定的特征性,再结合患者发病年龄、性别、部位及AFP检查等资料有助于提高其术前诊断的准确性,但确诊仍需依赖病理。
[Abstract]:Objective to investigate the imaging features and pathological basis of primary extragonadal endodermal sinus tumor (est) and to improve the understanding of the tumor. Methods the clinical and imaging data of 17 cases of pathologically proved primary extragonadal EST were retrospectively analyzed. The clinical features of CT and MRI were summarized and compared with the results of operation and pathology. Results the tumors were located in anterior mediastinum in 5 cases, retroperitoneal in 1 case, sacrococcygeal in 8 cases, craniocerebral in 3 cases, male 7 cases, female 10 cases. Ct and MRI showed large soft tissue mass. Round, oval or irregular shape, density and signal intensity inhomogeneity in 13 cases, solid mass in 4 cases, solid mass in 4 cases, solid part of enhanced scan showed moderate to high enhancement, In 10 cases of cystic partial unenhanced tumor, the serological examination of serological examination showed that the AFP of serum alpha-fetoprotein was significantly increased in 10 cases. The pathological manifestation was that the tumor tissue was diverse, and the interstitial cells were arranged into loose reticular structure. S-D corpuscles and eosinophilic corpuscles were found in the patients. Conclusion the imaging features of primary extragonadal EST have some characteristics. Combining with the age, sex, site and AFP examination of the patients, it is helpful to improve the accuracy of preoperative diagnosis. But the diagnosis still depends on pathology.
【作者单位】：郑州大学人民医院河南省人民医院影像科河南省神经疾病影像诊断与研究省级重点实验室;
【分类号】：R445.2;R730.44;R736.8

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