异位嗜铬细胞瘤的临床及CT诊断

Clinical and CT diagnosis of ectopic pheochromocytoma

目的 :总结异位嗜铬细胞瘤的临床及CT表现特点 ,旨在提高对本病的认识。方法 :回顾性分析经手术及病理证实的 13例异位嗜铬细胞瘤的临床资料和CT表现 ,分析其临床症状、肿块部位、大小、边缘、形态、密度和强化特征。结果 :良性者 11例 ,边界清晰 ;恶性者 2例 ,边界不清或清楚。肿瘤在CT上表现为圆形、椭圆形肿块 ;大多数异位嗜铬细胞瘤CT平扫示瘤体密度多均匀 ,增强扫描动脉期示瘤体明显强化 ,且门脉期多数仍呈持续强化。结论 :本病好发于中青年人 ,临床上多有高血压和儿茶酚胺分泌增多引起的代谢紊乱症状 ,多数生化检查有阳性改变。肿瘤好发于脊柱旁 ,尤以腹部脊柱旁最为多见。CT表现典型者诊断容易 ,但CT表现不典型者诊断较难 ,需结合临床资料。对于恶性者 ,CT图像上缺乏特征性表现 ,易误诊为其他恶性肿瘤。

Objective:To summarize clinical data and CT features of ectopic pheochromocytoma and to improve the ability to recognize this disease.Methods:Clinical data and CT findings in 13 cases of pathologically proved ectopic pheochromocytoma were retrospectively analyzed, focusing on the clinical symptoms of patients and the position, size, margin, morphology, density and enhancement pattern of tumors.Results:11 cases were benign presenting with definite edges; 2 cases were malignant presenting with indefinite or definite edges; all tumors presented as round or oval shape; a majority of 13 tumors showed homogeneous density on precontrast scanning while showed marked enhancement on the arterial phase scanning and still remained enhancement on the portal venous phase scanning.Conclusion:The youth and the middle-aged people are easier to suffer from this disease. Most patients have high blood pressure, metabolic disorder associated with catecholamine over-released into the blood by tumors, and positive findings in biochemical examinations. Ectopic pheochromocytoma is inclined to occur beside the spine,especially beside the lumbar spine. The cases with typical CT findings can be correctly diagnosed without difficulty, but other cases with atypical CT findings cannot be diagnosed easily unless refered to clinical data. Malignant ectopic pheochromocytoma is apt to be misdiagnosed as other malignant tumors for lack of characteristic CT signs.