纵隔原发性内胚窦瘤3例临床病例分析与文献复习

Clinical analysis and literature review of 3 cases of mediastinal endodermal sinus tumour

目的：分析原发纵隔内胚窦瘤的临床影像学表现及病理特征。方法：回顾性分析3例经手术和病理证实的原发纵隔内胚窦瘤的临床、影像及病理资料。结果：3例肿块均位于前纵隔，肿瘤横断面最大长径及短径的平均值分别为（13.0±4.2）、（8.2±1.3） cm。两例血清AFP检测浓度均明显高于正常。CT和MRI扫描示巨大不规则囊实性肿块，密度/信号不均匀，增强后分隔及实性部分轻度至中度强化。3例均取得手术病理结果，免疫组织化学表达AFP（＋），PLAP部分（＋），CK-pan（＋），CK-L（＋）， Ki-67约70%~95%（＋）。结论：原发纵隔内胚窦瘤的术前综合分析和评估很重要，影像学检查对其诊断具有重要意义，病理学特征可以指导其进一步的治疗和监测预后。

Objective：To analyze the clinical and imaging ifndings and pathologic characteristics of primary mediastinal endodermal sinus tumour. Methods： Three cases of primary mediastinal endodermal sinus tumours confirmed by surgery and pathology were retrospectively reviewed in the clinical, imaging and pathological data. Results：Three masses were located in the anterior mediastinum, cross-sectional average maximum long diameter and short diameter of tumor were （13.0±4.2） and （8.2±1.3） cm. Serum AFP detection concentrations were significantly higher than normal in 2 cases. Computed tomography （CT） and magnetic resonance imaging （MRI） scan showed large irregular heterogenous mass, with uneven density and signal intensity, which showed enhanced mild to moderate separation and solid part. All cases conifrmed by pathology. Immunohistochemical expression as follow：AFP （＋）, PLAP part （＋）, CK-pan （＋）, CK-L （＋）, Ki-67 about 70%~90%（＋）. Conclusion：Preoperative comprehensive analysis and evaluation are very important for primary mediastinal endodermal sinus tumour. Imaging examination is of great value for the diagnosis, pathological features can guide its further treatment and the prognosis monitoring.