论文部分内容阅读
目的探讨节细胞性副神经节瘤的影像表现及其临床病理学特点。资料与方法结合临床病理特征及文献,回顾性分析3例经手术病理证实的节细胞性副神经节瘤的影像表现。3例均行全消化道钡剂造影及CT平扫与增强。结果 CT检查示肿块分别位于十二指肠降段、上段空肠及中段空肠,3例均表现为肠腔内软组织密度肿块,肿块最大直径1.6～4.9 cm。3例病灶均未见钙化、出血及包膜。增强后上段空肠病灶呈明显周边强化,中央见无强化区,周围见肿大淋巴结;余2例表现为明显均匀强化。上段空肠病灶钡剂造影表现为局部肠管扩张,肠管内见一较大充盈缺损影,局部黏膜变平,肠管柔软,蠕动正常;余2例钡剂造影未见异常。3例均位于黏膜下,肿块实性质软,切面见丰富血管网,未见包膜。镜下全部肿块均由上皮样细胞、神经节样细胞及梭形细胞三种细胞构成。免疫组织化学标记上皮样细胞均表达嗜铬粒素A(CgA)、突触素(Syn)及神经元特异性醇化酶(NSE),1例亦表达细胞角蛋白(CK);梭形细胞均表达神经丝蛋白(NF)及S-100蛋白;神经节样细胞表达NF、NSE。结论节细胞性副神经节瘤的影像表现有一定特点,但缺乏特异性,确诊需结合组织病理学及免疫组织化学检查。
Objective To investigate the imaging features and clinicopathological features of gangliocytic paraganglioma. Materials and Methods Combined with clinicopathological characteristics and literature, retrospective analysis of 3 cases of ganglion cell ganglionematosis confirmed by surgery and pathology was performed. Three patients underwent total gastrointestinal barium angiography and CT scan and enhancement. Results The CT examination showed that the tumors were located in the descending segment of the duodenum, the upper jejunum and the middle jejunum, respectively. All of the 3 cases showed soft tissue density mass in the intestine, with a maximum diameter of 1.6 ~ 4.9 cm. No lesions were found in 3 cases of calcification, hemorrhage and capsule. After the enhancement of the upper jejunum lesions were significantly peripheral enhancement, the central see no enhanced area, see around the enlarged lymph nodes; the remaining 2 cases showed markedly uniform enhancement. Upper gastrointestinal jejunal barium showed angiography of local bowel dilatation, see a larger filling defect in the intestine, local mucosal flattening, intestinal soft, normal motility; more than 2 cases of barium anomalies were normal. 3 cases were located in the submucosa, the mass is really soft, see section rich vascular network, no envelope. All the tumors under the microscope were epithelial cells, ganglion cells and spindle cells composed of three kinds of cells. Epithelial-like cells in immunohistochemical staining all expressed CgA, Syn and NSE, and 1 also expressed cytokeratin (CK). Both spindle cells Express neurofilament (NF) and S-100 protein; ganglion-like cells express NF and NSE. Conclusions Pancytic paraganglioma has some features of imaging manifestations, but it lacks specificity and needs to be combined with histopathology and immunohistochemistry.