软组织黏液样脂肪肉瘤的超声表现与病理对照分析

Comparison between ultrasonic manifestations and pathologic findings of soft tissue myxoid liposarcoma

目的分析软组织黏液样脂肪肉瘤(myxoid liposarcoma,MLS)的超声表现特征。方法回顾性分析2006年1月—6月10例经术后病理证实为软组织MLS患者的超声表现特征,以及临床与病理资料。结果 10例患者的超声表现:病变累及层次位于肌肉内8例、皮下组织及肌层内2例;团块最大径平均值为(71.1±39.4)mm;10例患者的团块边界均清楚,8例形态规则,9例后方回声增强;10例患者均为实性团块伴黏稠液性区(弱回声为主9例,其中内有强回声区存在5例,强回声为主1例)。血流评级:0级3例,Ⅰ级3例,Ⅱ级2例,Ⅲ级2例。病理学检查结果显示:中高分化7例,低分化2例,MLS/不典型脂肪瘤混合1例。结论软组织MLS超声表现特征为好发于肌层的较大团块,边界清楚,形态规则,后方回声多增强,内部可见黏稠液性区,团块内多有不同程度的强回声区存在,血流情况与黏液区多少与分化程度有关,混合其他成分将影响其超声表现。

Objective To analyze the ultrasonic manifestations of myxoid liposarcoma（MLS） in soft tissues.Methods We retrospectively analyzed the ultrasonic characteristics of 10 cases of soft tissue MLS which were pathologically confirmed between January and June 2006. Results Ultrasonic manifestations： 8 cases occurred in muscles and 2 in subcutaneous tissues and muscles; the maximum mass diameter was（71.1±39.4） mm; 10 cases had clear border, 8 had regular shape, and 9 had posterior echo enhancement; 10 cases were all solid masses with mucous liquid zone（9 cases had mainly weak echo, among which 5 had strong echo areas; 1 case had mainly strong echo）; bloodstream grade： 3 cases belonged to level 0, 3 level Ⅰ, 2 level Ⅱ, and 2 level Ⅲ. Pathologic findings： 2 cases had low differentiation;1 case was a mixture of MLS and atypical lipoma with mainly strong ultrasonic echo; the rest 7 cases had middle or high differentiation. Conclusions Ultrasonic manifestations of soft tissue MLS are mostly large masses in the muscular layer with clear border, regular shape, posterior echo enhancement and mucous liquid zone. Various degrees of strong echo zone exist in the masses. Bloodstream and mucous liquid zone are correlated with differentiation degree, and ultrasonic manifestations can be influenced if other factors exist.