结肠粘液腺癌的CT诊断及病理基础

CT diagnosis and its pathologic basis of colonic mucinous carcinomas

目的:探讨结肠粘液腺癌的CT特点及病理基础。方法:分析9例结肠粘液腺癌的CT及病理表现。结果:9例均发现异常,主要特征性CT征象有:结肠壁局限性显著增厚7例,其中2例几无强化;结肠腔外囊性肿块5例,结肠腔内囊性肿块3例,其中5例囊壁明显厚薄不均,3例伴壁结节形成,2例见钙化;腹膜播种1例。经与病理对照显示:7例囊性肿块及2例无强化的增厚肠壁与粘液腺癌特有的“粘液湖”有关;5例肠外囊性肿块,3例系肿瘤直接浸润肠浆膜外形成,1例为肿瘤继发阑尾粘液囊肿,另1例可能为结肠憩室或深在性囊性结肠炎癌变所致。结论:伴局限性肠壁增厚的肠内外囊性肿块,无强化的局限性肠壁增厚、钙化及腹膜种植转移是结肠粘液腺癌的主要CT表现特点,与常见的结肠腺癌不同。

Objective:To analyse CT characteristic features and its pathologic basis of colonic mucinous carcinomas.Meth ods:CT features and its pathologic correlation in9cases of colonic mucinous carcinomas were reported.Results:The main characteristic CT findings in9cases included:local bowel wall thickening in7cases,of which2cases did not show en-hancement,extraluminal cystic masses were seen in5cases,intraluminal cystic masses seen in3cases,of which5cases having an irregular cystic wall,nodules were seen in3cases and calcification in2cases,peritoneum seeding metastasis in one case.After compared with pathologic findings,it showed:the cystic masses in7cases and no enhanced thickening bowel wall in2cases were correlated to the characteristic'mucinous lake'in the tumor ,the reasons for extraluminal cystic mass in5cases were direct infiltration of the serosa in3cases,secondary appendiceal mucinous cyst in one case,and another case might be caused by cystic colonitis or colonic diverticulosis.Conclu sion:Extra-or intra-luminal cystic masses with local bowel wall thickening,no en hanced local bowel wall thickening,calcification and peritoneum seeding metastasis are the main characteristic CT features of colonic mucinous carcinomas,which are different from common colonic carcinomas.