【摘要】 目的:分析弥漫型腱鞘巨细胞瘤(D-GCTTS)的临床、病理、影像诊断和鉴别诊断特点,提高对D-GCTTS的认识。材料与方法:收集2例经病理证实的D-GCTTS患者的临床、影像、手术及病理资料。术前均进行X线平片、CT平扫、MRI平扫和增强扫描。分析D-GCTTS的临床和影像特征。结果:两例患者无特征性临床表现。X线平片骨质及关节间隙正常,仅见关节周围软组织肿胀。CT平扫:关节周围不规则均匀等密度肿块,边缘清楚;与邻近骨质关系密切,但没有明显的骨质破坏。MRI扫描各序列均以低信号为主,其中以T2WI信号最低,增强扫描肿块呈中等程度的不规则强化。手术所见:关节旁棕褐色肿物,包膜不完整,边界清楚,与关节囊和韧带紧密相连。镜下见类滑膜细胞的单核组织细胞、多核巨细胞和炎症细胞,泡沫细胞和含铁血黄素颗粒沉积。结论:MRI对于D-GCTTS的诊断具有极高的敏感性和特异性。更多还原

【Abstract】 Objective: To review clinical,pathological and imaging features of diffuse giant cell tumor of tendon sheath(D-GCTTS) and to elevate recognization for this rare benign tumor. Materials and Methods: To analyse the clinical,pathological and imaging data from two patients with pathologically confirmed D-GCTTS,who underwent the preoperative CR,CT and MRI plain-scan and enhanced-scan. Results: Radiographic examination showed no bony and joint abnormality,iso-dense mass in the soft tissue. CT scan showed an increased attenuation multilobular mass with clear margin; there were no bony destruction except sclerotic cortex and small cysts were found in the irregularly thickening cortex. MRI showed that the lesions have the similar low-signal intensities in the different sequences,specifically on T2WI. Within the removed specimen,there were two well-encapsulated solid elastic brownish masses,with high cellularity feartures consisting of synovial-like mononuclear mesenchymal cell,multinucleate giant cells,a few foam cells,hemosiderin desposition and inflammatory cells. Conculsion: MRI is a high sensitive and specific examination for diagnosis of D-GCTTS.更多还原