肾原发性髓外浆细胞瘤的CT表现

The CT Manifestation of Renal Extramedullary Plasmacytoma

目的探讨肾原发性髓外浆细胞瘤(EMP)的影像学特点,以提高对本病的诊断准确率。方法回顾性分析经病理证实的8例EMP患者的影像学资料,总结其特征。结果8例患者中,位于左肾5例,位于右肾3例,均为单发病灶;病灶最大直径24~106 mm,平均直径52 mm,肿瘤大部均位于肾皮质外,包绕肾脏生长,均呈分叶状,6例密度均匀,2例密度不均;8例肿瘤边界清楚;7例肾脏呈受压改变;增强扫描肿块均呈中-重度强化,强化较均匀,肿块强化程度均低于肾皮质,肿瘤内及周边均可见迂曲增粗的血管影。结论EMP影像学表现具有一定特征性,肿瘤内密度均匀,边界清楚,大多数位于肾皮质外,包绕肾脏生长,肾脏位于肿瘤中央似“夹心饼干”,肾脏大多数受压变形,增强扫描肿瘤呈中-重度强化,强化均匀,肿瘤内及周边可见迂曲增粗的血管影。

Objective To investigate the imaging features of primary extramedullary plasmacytoma(EMP)of the kid-ney,so as to improve the diagnostic accuracy of this disease.Methods The imaging data of 8 patients with EMP con-firmed by pathology were analyzed retrospectively,and their characteristics were summarized.Results Among the 8 pa-tients,5 patients were located in the left kidney and 3 patients were located in the right kidney.All of them were single le-sions.The maximum diameter of the lesions was 24-106 mm,and the average diameter was 52 mm.Most of the tumors were located outside the renal cortex and grew around the kidney.All of them were lobulated.The density of 6 patients was uniform,and the density of 2 patients was uneven.Tumor boundary was clear in 8 cases.The kidneys of 7 cases showed compression changes.On enhanced scanning,the masses showed moderate to severe enhancement,and the enhancement was more uniform.The extent of enhancement of the masses was lower than that of the renal cortex.There were tortuous and thickened vascular shadows in and around the tumors.Conclusion The imaging features of EMP have certain charac-teristics.The density of the tumor is uniform and the boundary is clear.Most of the tumors are located outside the renal cortex and grow around the kidney.The kidney is located in the center of the tumor like a“sandwich biscuit”.Most of the kidneys are compressed and deformed.The tumor shows moderate to severe enhancement on enhanced scanning,and the enhancement is uniform.The tortuous and thickened vascular shadows can be seen in and around the tumor.