腹腔原发性滑膜肉瘤的CT诊断(附2例报道并文献复习)

CT diagnosis of primary intra-abdominal synovial sarcoma(two cases report and literature review)

目的:探讨腹腔滑膜肉瘤(synovial sarcoma,SS)的CT表现。方法:回顾并分析2例经病理学检查证实的腹腔SS患者的CT表现并复习文献。结果:2例患者SS分别位于腹膜后、大网膜,大小分别为12 cm×13 cm×18 cm、5 cm×7 cm×6 cm,边界清晰,密度不均匀,CT值为13~54 Hu,有出血、囊变,合并腹盆腔积液,增强扫描明显不均匀强化,延迟扫描趋向于均匀。结论:腹腔SS非常少见,CT表现有一定特点,多表现为位置较深在,较大分叶状软组织肿块,边界清。肿块内常见出血、坏死、囊性变。增强扫描明显不均匀强化,有延迟趋向于均匀强化的特点,常合并腹盆腔积液,腹盆腔未见肿大淋巴结。CT检查有助于肿瘤的定位,以及观察肿瘤与周围组织结构关系情况。

Objective:To discuss the CT manifestations of primary intra-abdominal synovial sarcoma(SS).Methods:The CT manifestations of 2 cases with pathology proved primary intra-abdominal SS were retrospectively analyzed and the literatures were reviewed.Results:Two cases of SS were located in the retroperitoneum and the greater omentum,and the sizes were 12 cm×13 cm×18 cm and 5 cm×7 cm×6 cm.The boundary was clear and the density was uneven.The CT value was 13-54 Hu.There were hemorrhage,cystic degeneration,abdominal and pelvic effusion.The enhanced scan is obviously uneven and the delayed scan tends to be uniform.Conclusion:SS of abdominal cavity is very rare tumor.Certain characteristic CT manifestations could be shown,mostly manifested as a deep and large lobulated soft tissue masses with clear boundaries.Hemorrhage,necrosis and cystic degeneration are common in the masses.Uneven as well as delayed uniform enhancement are assessed after enhanced scan.Abdominal and pelvic cavity effusion is often combined,and no enlarged lymph node is found in abdominal and pelvic cavity.CT examination will help to locate the tumor and observe the relationship between the tumor and surrounding tissues and structures.