胆管内乳头状黏液性肿瘤二例并文献复习

The Imaging Manifestations of Intraductal Papillary Mucinous Tumors

目的探讨临床少见的胆管内乳头状黏液性肿瘤的影像表现。方法结合文献分析2例经病理证实的胆管内乳头状黏液性肿瘤患者的CT、MRI表现特点。结果 2例在CT、MRI检查时均显示胆管扩张,但无确切肿块,ERCP显示胆管内有充盈缺损,内镜下十二指肠乳头处见黄绿色胶冻样黏液,病理诊断分别为腺体乳头状增生并黏液内癌细胞和乳头状腺瘤。结论影像学检查表现为胆管瘤样扩张,MRCP示扩张胆管内信号不均,其内可见有充盈缺损,内镜检查发现十二指肠乳头处黄绿色胶冻样黏液可提示胆管内乳头状黏液性肿瘤诊断,但最终诊断依赖于病理检查。

Objective To investigate the imaging features of intraductal papillary mucinous tumors. Methods The 2 cases of the intraductal papillary mucinous patients which confirmed by pathology were reported,and their CT and MRI manifestations and characteristics were analyzed combining with the literature. Results The pathology of the 2 cases,showing bile duct dilation but no exact mass on CT and MRI,with filling defect in the bile duct on ERCP,was papillary hyperplasia and mucus gland cancer cells and papillary adenoma. We see yellow green jelly like mucus glands in the duodenal papilla under the endoscope. Conclusion Imagings show bile duct ectasia,where the signal were uneven with filling detect on ERCP. But the findings of gelatinous mucus in duodenal papilla under the endoscope was characteristic. The final diagnosis depends on pathology.