胰腺肉瘤样癌的多层螺旋CT检查特征

Multi slice computed tomography for the diagnosis of pancreatic sarcomatoid carcinoma

  • 摘要: 胰腺肉瘤样癌是非常罕见的胰腺恶性肿瘤。本研究回顾性分析2001年3月至2013年1月江苏省苏北人民医院收治的8例胰腺肉瘤样癌患者的临床资料,并总结其CT影像学特征。CT检查结果显示:8例胰腺肿瘤均为囊实性,呈外生性生长,其中位于胰头部2例、胰颈部1例、胰体部3例、胰尾部2例。肿瘤以类圆形和椭圆形为主,直径(短径)为(7.2±1.8)cm(6.3~9.6 cm)。CT平扫结果示瘤体呈稍高密度或等密度影,边界清晰;瘤体内均发生囊变,瘤内无出血表现,1例瘤体内出现结节小钙灶。CT增强扫描结果示:瘤体实性成分呈中等强化;门静脉期及延迟期瘤体强化高于正常胰腺实质,但动脉期低于正常胰腺实质;瘤体三期增强扫描强化程度均低于主动脉。8例胰腺肉瘤样癌均有完整包膜,包膜未见异常强化。肿瘤与周围淋巴结和脏器关系:胰周淋巴结肿大3例、侵犯脾动脉2例、侵犯结肠脾曲2例、侵犯十二指肠浆膜或肌层1例。总结胰腺肉瘤样癌的CT检查特征,可为该病的诊断、鉴别诊断及治疗提供帮助。

     

    Abstract:

    Pancreatic sarcomatoid carcinoma is an extremely rare malignant tumor. The clinical data and computed tomography images of 8 patients with pancreatic sarcomatoid carcinoma who were admitted to the Subei People′s Hospital from March 2001 to January 2013 were retrospectively analyzed. The results of computed tomography showed that 8 tumors were cystic and solid, showing exophytic growth. Two tumors were located in the pancreatic head, 1 in the pancratic neck, 3 in the body of pancreas, and 2 in the tail of the pancreas. The shape of the tumors were round or ellipse, and the mean tumor diameter was (7.2±1.8)cm (range, 6.39.6 cm). The plain scan of computed tomography showed that the attenuation of the tumors was mild hyperdense (7 cases) or equal to pancreatic tissue (1 case). Tumors were solid with cystic components, and no hemorrhage within the tumor was detected. Small calcification nodule was detected in 1 case. The enhanced scan of computed tomography showed that the enhancement of the tumor was moderate; the enhancement of the tumor was higher than that of normal pancreatic parenchyma during venous phase and delayed phase, while lower than that of normal pancreatic parenchyma on arterial phase; the enhancement of tumors was significantly lower than that of aorta during all the enhanced phases. All the tumors had complete capsule, and abnormal enhancement of the capsule was not detected. Three tumors had peripancreatic lymphadenectasis, 2 had infiltration of splenic artery, 2 had infiltration of splenic flexure of colon and 1 had infiltration of duodenal serosa or muscle. Familiarity with the imaging features of the pancreatic sarcomatoid carcinoma can help surgeons to make a suggestive diagnosis.

     

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