摘要
目的:探讨肠道炎性肌成纤维细胞瘤(inflammatory myofibroblastic tumor,IMT)的计算机体层成像(computed tomography,CT)表现及病理学特征。方法:回顾并分析经手术后病理学检查证实的5例肠道IMT患者的CT影像学资料,并与病理学检查结果对照。术前5例均行CT检查,其中2例行腹部平扫、增强扫描,3例仅行腹部增强扫描。结果:5例IMT患者中男性1例,女性4例,年龄43~67岁,平均年龄56岁。1例发生于直肠,2例位于小肠,2例位于盲肠。1例呈向肠管外生长的囊实性肿块,增强扫描实性成分呈现中度强化,伴病灶内片状低密度影及病灶边缘线样钙化影。2例呈肠道管腔内实性肿块,呈明显不均匀强化,其内可见小血管强化影,其中1例发生转移。2例呈向肠道管腔外生长的实性肿块,呈渐进性、延迟性明显强化,病灶局部结节样、环形强化,此两例病灶伴有灶区肉瘤样变。组织学上肿瘤由增生的梭形肌成纤维细胞和成纤维细胞构成,伴间质炎性细胞浸润,免疫组织化学结果显示平滑肌肌动蛋白(smooth muscle actin,SMA)、vimentin的阳性百分率分别为80%、60%。结论:肠道IMT是非常少见的肿瘤,其影像学表现在一定程度上可反映病理学特征,并且有助于该病的诊断。
Objective:To explore the CT and pathological features of intestinal inflammatory myofibroblastic tumor(IMT).Methods:The CT features of 5 cases pathologically confirmed IMT were retrospectively reviewed,and compared with the pathological features.Preoperative CT examination was performed in all 5 patients,including 2 patients who underwent plain abdominal scan and enhanced abdominal scan,and 3 patients who underwent only enhanced abdominal scan.Results:There were 1 male and 4 female patients,aged 43~67 years,with an average age of 56 years.The tumor was located in rectum(n=1),small intestine(n=2),cecum(n=2).One case was cystic and solid with exophytic growth,the solid components showed moderate enhancement,and the lesions were accompanied by flaky low-density shadow and marginal line-like calcification shadow.There were 2 cases of solid mass in the lumen of the intestinal tract,which presented obvious non-uniform enhancement,and the enhancement shadow of small blood vessels could be seen in it,among which 1 case had metastasis.The lesions in 2 cases were solid masses growing outside the lumen of the intestinal tract,and the enhanced scan showed progressive and delayed obvious enhancement,local nodular enhancement and ring enhancement.The lesions in these 2 cases were accompanied by focal sarcomatoid lesions.Histologically,the tumors consisted of proliferating spindle myofibroblast and fibroblast cells,accompanied by variable infiltration of interstitial inflammatory cells.Immunohistochemistry showed that the percentage of positive staining for smooth muscle actin (SMA), vimentin was 80%, 60%, respectively. Conclusion: Intestinal IMT is a very rare tumor, and its imaging features can reflectpathological characteristics, to some extent, and which is helpful for the diagnosis of this disease.
作者
孙骏
沈力
蒋记心
叶靖
施斌斌
SUN Jun;SHEN Li;JIANG Jixin;YE Jing;SHI Binbin(Department of Medical Imaging,Northern Jiangsu People’s Hospital,Yangzhou 225001,Jiangsu Province,China;Department of Pathology,Northern Jiangsu People’s Hospital,Yangzhou 225001,Jiangsu Province,China)
出处
《肿瘤影像学》
2021年第1期30-35,共6页
Oncoradiology
基金
江苏省苏北人民医院院级扶持技术项目(fcjs201849)。
关键词
炎性肌成纤维细胞瘤
肠道肿瘤
CT
Inflammatory myofibroblastic tumor
Intestinal tumor
CT
