摘要
目的总结发生于盆腔及会阴区侵袭性血管黏液瘤(AAM)的临床特征、MRI表现及病理特点。资料与方法回顾性分析7例经手术病理证实为AAM患者的临床、MRI及病理学资料,7例AAM均为女性,年龄12~45岁,其中5例因发现会阴区肿物就诊,2例因会阴区AAM外院行手术治疗后复发就诊。结果 MRI表现:7例均为单发,最大径为5.9~15.7cm;6例形态不规则,无包膜,与邻近组织或器官分界不清;1例呈长柱形,边界清楚,可见假包膜。在T1WI上,AAM呈等信号(4/7)或等、低混杂信号(3/7)。在T2WI上,AAM呈高、低混杂信号,5例内见"旋涡征"。5例行增强检查,均呈明显强化,其中4例不均匀强化(2例内见"旋涡征"),1例均匀强化。在扩散加权成像上,AAM呈均匀(3/7)或不均匀(4/7)高信号。病理检查镜下可见AAM含有大量黏液样基质,其内可见散在分布的梭形及星芒状肿瘤细胞,局部可见丰富的动脉及静脉血管,边界处见肿瘤细胞浸润周围脂肪或肌肉组织。结论 AAM的特征性MRI表现为"旋涡征",与其含有稀疏的肿瘤细胞、大量黏液样基质及局部含有丰富的血管等病理特点相对应,对影像学诊断具有重要意义。
Purpose To summarize the clinical features, MRI features and pathological features of aggressive angiomyxoma （AAM） occurring in pelvic and perineal areas. Materials and Methods The clinical, MR and pathological data of 7 patients with AAM pathologically confirmed were retrospectively analyzed. Results Seven cases of AAM were all females, aged from 12 to 45 years old. Among them, 5 cases were treated due to perineal area tumors, and 2 cases due to relapses after surgical treatment of perineal area AAM in other hospitals. MRI findings 7 cases were single occurrence with the maximum diameter of 5.9-15.7 cm; 6 cases were in irregular shape, with no envelope and unclear borders with adjacent tissues or organs; 1 case was in long column shape with clear boundary and pseudocapsule visible. On T1WI, AAM showed equal signal （4/7） or equal, low mixed signal （3/7）. On T2WI, AAM showed high and low mixed signals with 5 cases of ＂vortex sign＂. 5 cases underwent routine enhancement examinations, all demonstrating significant enhancement, 4 cases of which displayed heterogeneous enhancement （＂vortex sign＂ was detected in 2 cases） and 1 case homogeneous enhancement. On diffusion weighted imaging, AAM manifested as homogeneous （3/7） or heterogeneous （4/7） high signal. Pathological examination showed that a large amount of mucin-like matrix was contained in AAM, and there were scattered fusiform and astral tumor cells and abundant arterial and venous blood vessels seen locally. Tumor cells infiltrated the peripheral fat or muscle tissues at the border. Conclusion The characteristic MRI of AAM is manifested as “vortex sign”, which corresponds to its pathological features such as sparse tumor cells, mucin-like matrix in large amount, and locally rich blood vessels, suggesting great significance for imaging diagnosis.
作者
孙孟言
王曼頔
王悦
吴焕文
陆菁菁
钟定荣
SUN Mengyan;WANG Mandi;WANG Yue;WU Huanwen;LU Jingjing;ZHONG Dingrong(Department of Radiology,Peking Union Medical College Hospital,Beijing 100730,China)
出处
《中国医学影像学杂志》
CSCD
北大核心
2018年第4期290-293,共4页
Chinese Journal of Medical Imaging
关键词
黏液瘤
盆腔肿瘤
会阴
磁共振成像
病理学
外科
女(雌)性
Myxoma
Pelvic neoplasms
Perineum
Magnetic resonance imaging
Pathology
surgical
Female Chinese Journal of Medical Imaging
2018
26 （4） 290-293
