摘要
目的：分析弥漫型腱鞘巨细胞瘤（D-GCTTS）的临床、病理、影像诊断和鉴别诊断特点，提高对D-GCTTS的认识。材料与方法：收集2例经病理证实的D-GCTTS患者的临床、影像、手术及病理资料。术前均进行X线平片、CT平扫、MRI平扫和增强扫描。分析D-GCTTS的临床和影像特征。结果：两例患者无特征性临床表现。X线平片骨质及关节间隙正常，仅见关节周围软组织肿胀。CT平扫：关节周围不规则均匀等密度肿块，边缘清楚；与邻近骨质关系密切，但没有明显的骨质破坏。MRI扫描各序列均以低信号为主，其中以T2WI信号最低，增强扫描肿块呈中等程度的不规则强化。手术所见：关节旁棕褐色肿物，包膜不完整，边界清楚，与关节囊和韧带紧密相连。镜下见类滑膜细胞的单核组织细胞、多核巨细胞和炎症细胞，泡沫细胞和含铁血黄素颗粒沉积。结论：MRI对于D-GCTTS的诊断具有极高的敏感性和特异性。
Abstract
Objective: To review clinical, pathological and imaging features of diffuse giant cell tumor of tendon sheath(D-GCTTS) and to elevate recognization for this rare benign tumor. Materials and Methods: To analyse the clinical, pathological and imaging data from two patients with pathologically confirmed D-GCTTS, who underwent the preoperative CR, CT and MRI plain-scan and enhanced-scan. Results: Radiographic examination showed no bony and joint abnormality, iso-dense mass in the soft tissue. CT scan showed an increased attenuation multilobular mass with clear margin; there were no bony destruction except sclerotic cortex and small cysts were found in the irregularly thickening cortex. MRI showed that the lesions have the similar low-signal intensities in the different sequences, specifically on T2WI. Within the removed specimen, there were two well-encapsulated solid elastic brownish masses, with high cellularity feartures consisting of synovial-like mononuclear mesenchymal cell, multinucleate giant cells, a few foam cells, hemosiderin desposition and inflammatory cells. Conculsion: MRI is a high sensitive and specific examination for diagnosis of D-GCTTS.
关键词
巨细胞瘤 /
磁共振成像
Key words
giant cell tumors /
magnetic resonance imaging
董 越;伍建林;李 莉.
弥漫型腱鞘巨细胞瘤的影像诊断和文献复习[J]. 中国临床医学影像杂志. 2007, 18(11): 785-788
DONG Yue;WU Jian-lin;LI Li.
Imaging diagnosis and literature review of diffuse giant cell tumor of tendon sheath[J]. Journal of China Clinic Medical Imaging. 2007, 18(11): 785-788
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