儿童肾透明细胞肉瘤CT影像表现特征

CT imaging features of renal clear cell sarcoma in children

目的探讨儿童肾透明细胞肉瘤(CCSK)的CT影像学表现特点。方法回顾性分析2014年8月至2022年4月经手术及病理证实的11例CCSK患者的CT平扫、三期增强扫描图像及病理免疫组化等资料,结合文献复习进行分析总结。结果位于右肾5例,左肾6例,肿瘤最大长径4~18 cm,5例大于10 cm,均呈膨胀性生长,CT平扫肿瘤呈等低混杂密度,肿瘤周边有囊变8例(72.7%),增强扫描动脉期肿瘤内有多发强化细小血管影9例(81.8%),实质期呈“虎斑样”强化6例(54.5%),延迟期肿瘤实性成分渐进强化9例(81.8%)。2例初诊时出现骨转移,2例腹膜后淋巴结转移。结论儿童CCSK的CT影像学表现具有一定的特征,有助于其诊断和鉴别诊断。

【Objective】To investigate the CT imaging features of clear cell sarcoma of the kidney(CCSK)in children.【Methods】The CT plain scan,three-phase enhanced scan images and pathological immunohistochemical data of 11 patients with CCSK confirmed by surgery and pathology from August 2014 to April 2022 were analyzed retrospectively,combined with literature review.【Results】There were 5 cases located in the right kidney and 6 cases in the left kidney.The maximum length of the tumor was 4–18 cm,and 5 cases were greater than 10 cm.All of them showed expansive growth.The tumor showed equal low hybrid density on plain CT scan,and there were cystic changes around the tumor in 8 cases(72.7%).On enhanced CT scan,there were multiple enhanced small vascular shadows in the tumor in the arterial phase in 9 cases(81.8%),and"tiger spot"enhancement in the substantive phase in 6 cases(54.5%),and progressive enhancement of solid components in the tumor in the delayed phase in 9 cases(81.8%).Bone metastasis occurred in 2 cases and retroperitoneal lymph node metastasis in 2 cases.【Conclusion】CT imaging findings of CCSK in children have certain characteristics,which are helpful for diagnosis and differential diagnosis.