十二指肠间质瘤的临床、CT影像与免疫组织化学特点初探

The Clinical,CT and Immunohistochemical Characteristics of Duodenal Stromal Tumors: A Preliminary Study

目的探讨十二指肠间质瘤的临床、CT影像及免疫组织化学特点。方法回顾性分析11例经手术病理证实的十二指肠间质瘤患者的临床、CT影像和病理学资料。结果临床表现为消化道出血6例、腹部隐痛不适2例、体检发现3例。肿瘤发生于十二指肠降部7例,水平部3例,升部1例。腔外生长8例,跨壁生长3例。瘤体最大径1.7~14 cm,平均6.9 cm。病灶呈圆形或类圆形3例,不规则形或分叶状8例。增强扫描4例显著均匀强化,7例显著不均匀强化伴坏死。免疫组织化学检查：平滑肌方向分化8例,缺乏分化特征2例,神经方向分化1例。结论十二指肠间质瘤具有相对特征性的CT影像和临床病理表现,认识这些特征有助于提高其诊断准确率。

Objective To investigate the clinical, CT and immunohistochemieal characteristics of duodenal stromal tumors. Methods The clinical data, CT manifestations and immunohistochemical results of 1 l patients with pathological- ly-proved duodenal stromal tumor were retrospectively analyzed. Results The clinical manifestations included gastrointes- tinal tract bleeding （ n = 6, 54.5% ） , abdominal pain or discomfort （ n = 2, 18.2% ） , and the disease was revealed by physical examination in 3 patients （27.3%）. The tumor was located at descending segment （n = 7） , horizontal segment （ n = 3 ） and ascending segment （ n = 1 ） of the duodenum. Pathologically, the tumor grew outside the duodenal lumen （ n = 8 ） or across the duodenal wall （ n = 3）. The maximum diameter of the tumors ranged from l. 7 em to 14 em with an average of 6.9 cm. The lesion took the form of round or oval mass （ n = 3 ） , or irregular or lobular mass （ n = 8 ）. On enhanced CT scan, the lesion showed remarkable homogeneous enhancement in 4 cases and striking inhomogeneous enhancement with necrosis in 7 cases. Immunohistoehemical results revealed that smooth muscle differentiation was seen in 8 cases （72. 7% ） , neural differentiation in one case （9.1%） and no obvious differentiation feature in 2 cases （ 18.2% ）. Conclusion Duodenal stromal tumors have certain specific CT features and clinic-pathologic characteristics, which are very helpful in improving its diagnostic accuracy..