良性转移性平滑肌瘤的临床及影像学特点分析并文献复习

Analysis of clinical and imaging features of benign metastatic leiomyoma and literature review

目的:通过分析良性转移性平滑肌瘤(BML)的临床及^(18)F-脱氧葡萄糖正电子发射型计算机断层显像/X线计算机体层扫描(^(18)F-FDG PET/CT)影像学特点,提高对BML的认识及诊断水平。方法:回顾分析经病理证实的3例BML患者的^(18)F-FDG PET/CT影像学表现,与其临床表现及病理结果相对照,结合既往文献,总结BML的^(18)F-FDG PET/CT影像学特点。结果:3例患者均为有子宫平滑肌瘤手术史的中年女性,平均年龄40岁。血清肿瘤学标记物均为阴性。病变部位:1例位于双肺;1例位于双肺及盆腔,1例位于腹盆腔。^(18)F-FDG PET/CT显像表现为边缘光滑的结节或肿块,大部分呈轻度葡萄糖代谢(SUVmax:1.8~2.8),仅其中1例右肺中叶病变呈中度葡萄糖代谢(SUVmax:4.1)。病理均提示为转移性平滑肌瘤,免疫组化表达肌源性标记物(α-SMA,Desmin)以及子宫平滑肌源性肿瘤标记物(ER,PR)。结论:BML是一种罕见的良性肿瘤,^(18)F-FDG PET/CT显像的主要特征在其诊断及后续病情监测中可发挥出重要的作用。

Objective:To improve the understanding and diagnostic accuracy of benign metastatic leiomyoma by analyzing the clinical and^(18)F-FDG positron emission computed tomography/X-ray computed tomography(^(18)F-FDG PET/CT)imaging features of benign metastatic leiomyoma.Methods:The imaging findings of^(18)FFDG PET/CT in 3 cases of benign metastatic leiomyoma patients confirmed by pathology were analyzed retrospectively,and were compared as well with their clinical manifestations and pathological results. Combined with the previous literatures,the imaging features of^(18)F-FDG PET/CT in benign metastatic leiomyomas were summarized.Results:The 3 patients were all middle-aged women, average age of 40 years,each with a history of uterine leiomyoma surgery.Serum oncological markers were negative.Location:1 in both lungs;1 in both lungs and pelvis,and 1 in abdomen and pelvis.The^(18)F-FDG PET/CT imaging showed nodules or masses with smooth edges,most of which showed mild glucose metabolism(SUVmax:1.8-2.8),except the right middle lobe lesion in one case showed moderate glucose metabolism(SUVmax:4.1).Pathology indicated metastatic leiomyomas,and the tumors presented immunohistochemical expression of myogenic markers(α-SMA,desmin)and uterine smooth muscle derived tumor markers(ER,PR).Conclusion:Benign metastatic leiomyoma is a rare benign tumor.The main features of^(18)F-FDG PET/CT imaging can play an important role in its diagnosis and subsequent monitoring.