结节型节细胞神经母细胞瘤的CT表现

发布时间：2018-12-10 22:45

【摘要】：目的探讨结节型节细胞神经母细胞瘤(GNBn)的CT表现特征。方法回顾性分析经手术、病理证实的10例GNBn的CT及病理学表现。结果 10例中9例为单发病灶,其中5例位于肾上腺,2例位于腹膜后,另3例分别位于纵隔、颈部、盆腔。10例中5例可见淋巴结转移,分别转移至腹膜后(2例)、主动脉旁(1例)、肝门部(1例)、两侧颈动脉鞘区(1例)。CT平扫肿瘤多为单个巨大分叶状低密度肿块,有完整的包膜或假包膜,内密度不均,可见散在或聚集状钙化灶。增强扫描多为不均匀强化,动脉期瘤体实性成分强化明显,静脉期实性成分持续强化,部分病例瘤周或瘤体内可见呈簇状或线状排列的血管影。10例GNBn的共同组织病理特点为以出血性/坏死性神经母细胞瘤结节为特征,同时可看到周围施万基质组织中的少量混合型节细胞神经母细胞瘤或节细胞神经瘤成分。免疫表型:S-100蛋白、CgA、Syn、NSE阳性,CD99阴性。结论 GNBn是一种神经嵴来源的胚胎性恶性肿瘤,其发病年龄、发病部位特异。CT平扫多密度不均,伴特征性钙化灶,增强扫描多为不均匀强化。确诊有赖于病理,免疫组织化学分型更有利于鉴别诊断。
[Abstract]:Objective to investigate the CT features of nodular ganglioneuroblastoma (GNBn). Methods the CT and pathological findings of 10 cases of GNBn proved by operation and pathology were analyzed retrospectively. Results among the 10 cases, 9 cases were single lesions, 5 cases were located in adrenal gland, 2 cases were located in retroperitoneum, the other 3 cases were located in mediastinum, neck and pelvic cavity respectively. Para-aorta (1 case), hepatic hilum (1 case), bilateral carotid sheath area (1 case). CT plain scan tumors were mostly a single large lobular low density mass, with complete capsule or pseudocapsule, uneven internal density. Scattered or aggregated calcification can be seen. Most of the contrast-enhanced scans were heterogeneous enhancement, the solid components of the tumor were obviously enhanced in the arterial phase, and the solid components in the venous phase were continuously enhanced. Vascular shadows arranged in clusters or lines were seen in some cases. The common histopathological features of 10 cases of GNBn were haemorrhagic / necrotic neuroblastoma nodules. A small amount of mixed ganglioneuroblastoma or ganglioneuroma components in the surrounding Schwann matrix tissue can also be seen. Immunophenotype: S-100 protein, CgA,Syn,NSE positive, CD99 negative. Conclusion GNBn is a kind of embryonic malignant tumor derived from neural crest, its onset age and location are specific. CT scan has uneven density, accompanied by characteristic calcification, and most of the enhanced scans are uneven enhancement. The diagnosis depends on pathology, and immunohistochemical typing is more helpful for differential diagnosis.
【作者单位】：河南省肿瘤医院放射科;
【分类号】：R739.4;R730.44

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