腹壁透明细胞癌1例的影像表现及文献复习

Imaging findings and literature review of 1 case of clear cell carcinoma of the abdominal wall

腹壁透明细胞癌非常少见,CT及磁共振成像(MRI)的特点是病灶位于下腹壁腹直肌内或腹直肌附近,生长多平行于腹直肌,边界清楚,呈实性或囊性,密度较均匀,增强扫描不均匀强化或无强化。为提高腹壁透明细胞癌的诊断准确性,本文对青岛大学附属威海医院2021年8月经过手术及病理确诊的1例腹壁透明细胞癌患者的临床资料、影像学表现及病理特征进行分析,并复习相关文献,以期为诊断提供参考。腹壁透明细胞癌患者的影像学表现为左侧腹直肌内病灶CT呈卵圆形软组织密度影,MRI T1WI呈等信号、T2WI呈混杂稍高信号,弥散明显受限,病灶边缘较清晰,增强扫描呈不均匀强化,内见斑片状无强化区。通过结合临床表现及影像学表现可作出定性诊断,确诊主要依靠病史和病理特征。

Clear cell carcinoma of the abdominal wall is very rare,and the characteristics of CT and magnetic resonance imaging(MRI)are that the lesion is located in or near the rectus abdominis muscle of the lower abdominal wall,the growth is mostly parallel to the rectus abdominis muscle,the border is clear,solid or cystic,and the density is relatively homogeneous,and the enhancement scans show inhomogeneous enhancement or no enhancement.In order to improve the diagnostic accuracy of clear cell carcinoma of the abdominal wall,this article analyzes the clinical data,imaging manifestations and pathological features of a patient with clear cell carcinoma of the abdominal wall who was diagnosed by surgery and pathology in August 2021 in Weihai Hospital Affiliated to Qingdao University,and reviews the relevant literatures,with the aim of providing reference for diagnosis.The imaging manifestations of patients with clear cell carcinoma of the abdominal wall were ovoid soft tissue density shadow on CT of the lesion in the left rectus abdominis muscle,isosignal on MRI T1WI,mixed slightly high signal on T2WI,with obvious restriction of dispersion,clearer edge of the lesion,uneven enhancement on enhancement scan,and patchy non-enhanced area inside.Qualitative diagnosis can be made by combining clinical manifestations and imaging manifestations,and confirmation of the diagnosis mainly relies on medical history and pathological features.