【摘要】 目的探讨十二指肠间质瘤的临床、CT影像及免疫组织化学特点。方法回顾性分析11例经手术病理证实的十二指肠间质瘤患者的临床、CT影像和病理学资料。结果临床表现为消化道出血6例、腹部隐痛不适2例、体检发现3例。肿瘤发生于十二指肠降部7例,水平部3例,升部1例。腔外生长8例,跨壁生长3例。瘤体最大径1.7~14 cm,平均6.9 cm。病灶呈圆形或类圆形3例,不规则形或分叶状8例。增强扫描4例显著均匀强化,7例显著不均匀强化伴坏死。免疫组织化学检查:平滑肌方向分化8例,缺乏分化特征2例,神经方向分化1例。结论十二指肠间质瘤具有相对特征性的CT影像和临床病理表现,认识这些特征有助于提高其诊断准确率。更多还原

【Abstract】 Objective To investigate the clinical,CT and immunohistochemical characteristics of duodenal stromal tumors. Methods The clinical data,CT manifestations and immunohistochemical results of 11 patients with pathologically-proved duodenal stromal tumor were retrospectively analyzed. Results The clinical manifestations included gastrointestinal tract bleeding( n = 6,54. 5%),abdominal pain or discomfort( n = 2,18. 2%),and the disease was revealed by physical examination in 3 patients(27. 3%). The tumor was located at descending segment( n = 7),horizontal segment(n = 3) and ascending segment(n = 1) of the duodenum. Pathologically,the tumor grew outside the duodenal lumen(n =8) or across the duodenal wall( n = 3). The maximum diameter of the tumors ranged from 1. 7 cm to 14 cm with an average of 6. 9 cm. The lesion took the form of round or oval mass( n = 3),or irregular or lobular mass( n = 8). On enhanced CT scan,the lesion showed remarkable homogeneous enhancement in 4 cases and striking inhomogeneous enhancement with necrosis in 7 cases. Immunohistochemical results revealed that smooth muscle differentiation was seen in 8 cases( 72.7%),neural differentiation in one case(9. 1%) and no obvious differentiation feature in 2 cases(18. 2%). Conclusion Duodenal stromal tumors have certain specific CT features and clinic-pathologic characteristics,which are very helpful in improving its diagnostic accuracy..更多还原