摘要
目的探讨直肠间质瘤的CT/MR表现和临床病理特征,并分析其预后。方法回顾性分析8例经病理证实的直肠间质瘤的CT和MR表现及其与临床病理间的关系。结果 8例均为恶性。黏膜下型1例,直径约2.6cm,表现为直肠壁不规则增厚并向腔内生长,表面可见小溃疡,低度恶性。壁间型3例,直径约0.7~10.0cm,小病灶局限于肌壁内,较大者横跨直肠壁并向腔内、外生长,病灶主体部分位于直肠壁外,增强后明显不均匀强化;1例合并直肠腺癌;1例极低度恶性,2例高度恶性。浆膜下型4例,直径约4.2~16.5cm,表现为直肠壁偏一侧类圆形或分叶状外生性软组织肿块,边界清晰,密度不均,富血供,可见坏死囊变及出血,直肠受压移位;1例可见左腹股沟区淋巴结肿大;2例高度恶性,2例中度恶性。所有病例均未出现肠梗阻。免疫组织化学结果:CD117阳性7例,CD34阳性5例,CD117和CD34均呈阳性4例,CD117阴性而CD34阳性1例,CD117阳性而CD34阴性3例。有5例进行了追踪随访,其中3例复发。结论直肠间质瘤非常少见,影像表现具有一定特征,免疫组织化学可以确诊,恶性程度较高,预后较差。
Objective To study the imaging manifestation and clinicopathologic characteristics of rectal stromal tumors. Methods The CT and MRI data of 8 patients with pathology proved rectal stromal tumors were retrospectively analyzed,and the correlation between the imaging features and pathological results were analyzed. Results All of 8 cases were malignant.One case was submucosal.It showed irregular thickening of the rectal wall with a diameter of about 2.6 cm,and small ulcers with low-risk could be seen.Three cases were intramural with diameters of about 0.7-10.0 cm.Small lesion located in rectum,and the larger lesions showed internal and external growth across the rectal wall and the main part of the mass was outside the rectum.They were heterogeneous enhancement.One case accompanied with adenocarcinoma.One case was extremely low-risk,two cases were high-risk.Four cases were subserous.The diameter was about 4.2-16.5 cm.CT showed round or lobular,well-circumscribed,exophytic,hypervascular,and heterogeneous masses with cystic necrosis and hemorrhage.They displaced rectum occasionally.Lymphadenopathy in the left groin was developed in one case.Two cases were high-risk,two cases were intermediated-risk.No cases developed intestinal obstruction.Results of immunohistochemistry: CD117 was positive in 7 cases,CD34 positive in five cases,CD117 and CD34 positive in four cases,CD117 negative but CD34 positive in one case,CD117 positive but CD34 negative in three cases.Five cases were followed up,among whom 3 cases recurred. Conclusions Rectal stromal tumor is rare.Imaging appearances of rectal stromal tumors are specific.Its final diagnosis depends on immunohistochemistry examination.It has generally higher degree of malignancy and the prognosis is relatively poor.
出处
《中国普外基础与临床杂志》
CAS
2011年第10期1109-1113,共5页
Chinese Journal of Bases and Clinics In General Surgery
关键词
直肠肿瘤
胃肠道间质瘤
X线体层摄影术
磁共振成像
病理学
Rectal neoplasm
Gastrointestinal stromal tumors
X-ray tomography
Magnetic resonance
Pathology