腹膜后平滑肌肉瘤的CT诊断与鉴别诊断——附6例报告及文献复习

CT Diagnosis and Differential Diagnosis of retroperitoneal Leiomyosarcoma (6 cases report and literature review)

目的探讨腹膜后平滑肌肉瘤的CT表现及鉴别诊断。方法分析6例手术病理证实的后腹膜平滑肌肉瘤,螺旋CT平扫加增强扫描,结合文献研究其定位和定性征象并讨论误诊原因及鉴别诊断。结果6例腹膜后平滑肌肉瘤,2例误诊为卵巢癌,2例误诊为恶性淋巴瘤。CT表现均为腹膜后不规则巨块型占位,边界不清5例(83%),全部病例未见钙化、出血、囊变的改变,肿块中央出现低密度3例(50%),4例(67%)包裹周边血管。结论腹膜后平滑肌肉瘤在定位、定性上均容易误诊,其CT表现特点是容易侵犯腹部血管,鉴别诊断包括腹膜后脂肪肉瘤、肾源性肿瘤、恶性神经类肿瘤、恶性淋巴瘤等。

Objective To explore CT diagnosis and Differential diagnosis of retroperitoneal Leiomyosarcoma. Methods 6 cases of retroperitoneal leiomyosarcoma were been studied which confirmed by operation and pathology. To study its location and pathological imaging characteristics, while discussing its misdiagnosis causes by review papers published in the world. Results 2 of 6 cases were been misdiagnosised by carcinoma of ovary,and 2 cases misunderstood by lymphangiosarcoma. CT features include retroperitoneal irregular mass with unclear rims （83%）. The mass was non- calcified, contained no fat, blood and cyst density.3 of 6 cases（50%）cases appeared central row density. 4 cases of 6（67%）domonstated invowing abdominal vessels. Conclusion Retroperitoneal Leiomyosarcoma may easily be misdiagnosised both in location and pathological characteristics. CT special features is Vascular involvement. The differential diagnosis of this diseases should include retroperitoneal lymphangiosarcoma liposarcoma, adrenal carcinoma, neurosarcoma and fibrosarcoma and so on.