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炎性肌纤维母细胞瘤的影像表现与病理分析

The Radiology Feathers and Pathological Analysis of Iflammatory Myofibroblastic Tumor

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【作者】 彭德新魏俊张翱陶学伟

【Author】 PENG Dexin;WEI Jun;ZHANG Ao;Jiangxi Cancer Hospital;

【通讯作者】 陶学伟;

【机构】 江西省肿瘤医院

【摘要】 目的分析炎性肌纤维母细胞瘤(IMT)的影像表现。方法回顾性分析经手术病理证实的IMT患者(n=11)的临床、影像及病理资料,含CT平扫(n=2)、CT增强(n=1)、CT平扫增强(n=6)、MRI平扫增强(n=2),探讨影像与病理特征的关系。结果 IMT均单发,边界清晰3例、不清8例(1例侵犯左肾),囊实性6例、实性5例。实性部分呈平扫稍低密度、"慢进慢出"样强化为主,囊性部分呈平扫低密度且无强化,并见囊壁规则环形线状强化(n=1)、边缘动脉期显著强化结节(n=1)、内部强化血管影(n=1)及"血管抱球征"(n=2)。T1WI呈等或稍低信号,T2WI、DWI呈稍高信号,增强扫描呈渐进性不均匀强化并小囊变、小网膜囊积液(n=1)或均匀中度强化(n=1)。免疫组化为Vim(+)(n=6),ALK(+)(n=4),Ki76 1%-20%。结论 IMT缺乏典型临床影像特征,瘤周炎性浸润、"慢进慢出"强化及纤维组织密度或信号对诊断有重要提示价值。IMT的影像表现与ALK、Ki67可能存在某些相关性。

【Abstract】 Objective To analyze imaging characteristics of inflammatory myofibroblastic tumor( IMT) and to improve diagnosistic capacity. Methods The clinical and radiological matericals of patients( n = 11) confirmed surgically and pathologically were analyzed retrospectively,and the correlations between radiology and pathology were discussed. Of all patients,CT pain scan( n = 2),CT enchanced( n = 1),CT pain and enchanced( n = 6),MRI pian and enchanced( n = 2),immunohistochemistry( n= 6) were performed. Results All of the cases were singal lesion with Well-defined and ill-defined cases of 3 and 8( 1 case with left kidney invasion) respectively. Mixed cystic or solid( n = 6) and pure solid( n = 5) IMT showed slightly low density mainly with slowly-in and out enchancement of solid margin and low density of cystic without enchancement,combing with cystic wall regularly liner enchancement( n = 1),marginal nodules obviously enchanced in arterial phase( n = 1),interner multiple blood vessels( n = 1),ball-holding sign( n = 2). On MRI,the masses revialed isointensity or slightly hypointensity on T1 WI,slightly hyperintensity on T2 WI and DWI,heterogenerously and progressively enchanced,combining with small cystics,omental bursa cyst( n =1),and homogenous moderately nchanced( n = 1). Immunohistochemistry revialed that the number of Vim( +),ALK( +) cases was 6,4,respectively,Ki67 ranged from 1% ~ 20%. Conclusion The clinical and raodiology manifestation of IMT may not so characterized,but signs such as inflammatory infltration,slowly-in and out enchancement,fibrous density or singal,may show important value on diagnosing. Besides,the radiology feathers of IMT may correlate with Alk and Ki67.

【基金】 江西省卫计委课题(编号:20185375)
  • 【文献出处】 实用癌症杂志 ,The Practical Journal of Cancer , 编辑部邮箱 ,2018年09期
  • 【分类号】R730.44;R445.2
  • 【被引频次】4
  • 【下载频次】239
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