盆部内胚窦瘤临床表现及CT特征

Clinical manifestations and CT features of pelvic endodermal sinus tumor

目的探讨内胚窦瘤临床及CT表现特点,提高诊断正确率。方法回顾性分析经组织学证实为内胚窦瘤14例的临床与CT表现,所有病例采用美国PICKER ULTRA Z螺旋CT作平扫及增强扫描检查,抽血检查甲胎蛋白(AFP)。结果主要临床表现为盆部包块,AFP均有不同程度升高,CT检查发现瘤体主要位于盆部中轴线,体积较大,常向下腹部特别是向骶尾部突出,边界多不规整,密度不均匀,常见程度不同的坏死囊变区域,但所有病例均未见钙化灶,增强扫描显示不均匀强化。结论内胚窦瘤CT表现有一定特点,结合AFP升高可以明确诊断,但要注意与横纹肌肉瘤、恶性畸胎瘤、神经母细胞瘤、淋巴肉瘤等鉴别。

Objective To explore the clinical manifestations and CT features of pelvic endodermal sinus tumors（PESTs）and to elevate the diagnostic accuracy.Methods The clinical manifestations and CT features of 14 patients with PESTs confirmed by histopathology were analyzed retrospectively.All patients underwent CT scans before and after contrast enhancement using Picker ultra spiral CT scanner and serum alpha-fetoprotein （AFP）examinations.Results Clinically, all the patients mainly appeared as intrapelvie mass and elevation of serum AFP level.CT scans demonstrated that the PESTs mostly located in the axle wire of the pelvis appeared large volume and often protruded towards into inferior abdomen,especially, sacroiliac area,sinmltaneously,their margins were uneven and the density was non-homo- geneous or often associated with necrotic and cystic change area in different extent but the calcified foci were not fuund in all eases.After contrast enhancement,PESTs presented non-homogeneous enhancement.Concluslon PESTs have some CT features and combine with clinically the elevation of serum AFP level,the definite diagnosis is not difficult but they should be carefully differentiated from rhabdomyosarcoma,malignant teratoma,neuroblastoma and lymphadenosarcoma,etc.