原发于骨上皮样血管内皮瘤的影像对比分析

Radiologic Signs Comparative Analysis of Osseous Epithelioid Hemangioendothelioma

目的:提高对骨上皮样血管内皮瘤(EHE)的认识和影像诊断水平。方法:回顾性分析经手术病理证实的6例骨上皮样血管内皮瘤的X线平片、CT、MR和临床病理,结合文献对比分析各检查方法的影像特征。结果:3个病例表现为多发病灶,分别位于股骨下段、胫腓骨及足部;2个病例病灶位于胫骨下段;1例病灶位于股骨近端。X线平片及CT平扫示多灶性溶骨性骨破坏、硬化边,部分病灶内见"栅栏样"骨嵴,MR上病灶呈稍长T1、长T2信号,增强后呈明显强化。免疫组化提示肿瘤细胞表达血管内皮细胞标记如CD3l、CD34、Vimentin、CK呈阳性。结论:骨上皮样血管内皮瘤有一定的影像学特征,X线平片、CT和MR检查能为临床诊断及鉴别诊断提供有价值的信息。

Objective： To improve knowledge and imaging diagnosis of bone epithelioid hemangioendothelioma （EHE）. Methods： We retrospectively analyzed X-ray, CT, MR and pathological data of six cases of bone epithelioid hemangioendothelioma which confirmed by operation and pathology, and summarize its imaging features. Results： Three patients＇ lesions, characterized by multiple osteolytic destruction, were located in distal femur, tibia, fibula and foot. Two cases of lesions were located in the lower tibia. One case of lesion was located in the proximal femur. The imaging features of X-ray and CT of these lesions were multifocal osteolytic bone destruction, hardening of the edge and there were fence -like lesions bone crests in part of the lesions. MR image features of these lesions were slightly long T1WI and long T2W1, and they had significant enhancement after contrast-enhanced scanning. Immunohistochemical studies showed that tumor cells CD31, Vimentin, CK（＋）, CD69 （Spotty ＋）, CD163 （spot）, FLI-1 （＋）, Ki67 （＋ 〈 10%）. Conclusion： EHE have some imaging characteristics. CT and MR imaging can provide valuable information for clinical diagnosis and differential diagnosis.