促结缔组织增生性小圆细胞肿瘤与淋巴瘤腹膜侵犯的CT表现及鉴别诊断

CT findings and differential diagnosis of desmoplastic small round cell tumor and lymphoma with peritoneal invasion

目的:总结促结缔组织增生性小圆细胞肿瘤(DSRCT)与淋巴瘤腹膜侵犯的CT表现,探讨两者的鉴别诊断征象。方法:回顾性分析经病理证实的14例DSRCT患者(DSRCT组)、11例淋巴瘤腹膜侵犯患者(淋巴瘤腹膜侵犯组)的临床表现及CT动态增强扫描征象。比较2组病变的CT征象。结果:DSRCT组较淋巴瘤腹膜侵犯组盆腔肿块、持续强化、坏死均易发生(均P<0.05);淋巴瘤腹膜侵犯组肿块呈轻度均匀强化比例高于DSRCT组(P<0.05)。2组腹膜增厚、腹盆腔积液量,以及肝、肺、骨及淋巴结转移差异均无统计学意义(均P>0.05)。结论:DSRCT肿块常发生于盆腔(膀胱后间隙),可伴坏死,呈持续强化,好发于青年;淋巴瘤腹膜侵犯肿块常发生于腹腔,多呈轻度均匀强化。CT对DSRCT与淋巴瘤腹膜侵犯的鉴别诊断有一定价值。

Objective:To summarize the CT findings of desmoplastic small round cell tumor(DSRCT)and lymphoma with peritoneal invasion and to explore the differential diagnostic signs between them.Methods:14 patients with DSRCT and 11 patients with lymphome with peritoneal invasion confirmed by pathology were collected and their clinical manifestation and CT dynamic enhancement features were retrospectively analyzed.CT signs of the two groups of lesions were compared.Results:Compared with the lymphoma group,the lesions of DSRCT group were more likely to develop pelvic masses,continuous enhancement and necrosis(all P<0.05),and the propotion of lesions with mild uniform enhancement in the lymphoma group was higher than that in DSRCT group(P<0.05).The thickening of the peritoneum,ascites volume,lymph node metastasis,and liver,lung and bone metastasis were not statistically significant in two groups(all P>0.05).Conclusions:DSRCT masses often occur in the pelvic cavity(retrovesical space),accompanied by necrosis and continuous enhancement,and often occur in young people.Masses of lymphoma with peritoneal invasion often occur in the abdominal cavity,showing mild uniform enhancement.CT has certain values in the diagnosis of DSRCT and lymphoma with peritoneal invasion.