摘要
目的探讨胃肠间质瘤（GISTs）的影像学和病理组织学特征。方法回顾性分析26例胃肠间质瘤的影像学资料,并与病理学做对照。结果26例GISTs中,位于小肠10例,胃8例,大肠6例,肠系膜和网膜各1例。其影像学特点和病理学表现如下：（1）肿块多为外生性生长（19例, 73．1％）,边缘光整,压迫邻近结构,肿瘤直径为5．1-23．5 cm,平均直径（11．6±5．9）cm;（2）肿块内部密度或信号不均匀,瘤内见坏死21例（80．8％）,出血15例（57．7％）,钙化3例（11．5％）;（3）在增强后的CT和MRI图像上,不均匀强化者21例（80．8％）,表现为肿块周边及内部斑片样强化,并可见条状强化的血管影12例;均匀强化5例（19．2％）;（4）远处转移见于肝（7例）和腹膜（4例）,但不伴淋巴结转移;（5）病理学：梭形细胞型18例（69．2％）,上皮细胞型6例（23．1％）,混合型2例（7．7％）;免疫组化染色：26例患者CD117全部阳性,22例患者CD34阳性。结论胃肠间质瘤典型特征为外生性生长,体积较大,瘤内可见条状血管影、出血和坏死;转移多见于肝和腹膜,无淋巴结转移。组织学分型以梭形细胞型最多见,其次为上皮细胞型。CT和MRI是诊断GISTs的理想方法。
Objective To investigate the imaging features and pathological manifestations of gastrointestinal stromal tumors （GISTs）. Methods The imaging characteristics and pathological manifestations of 26 surgically treated patients with histologically confirmed GISTs were retrospectively analyzed. Results The tumors were found to originate from the small bowel （n = 10）, stomach（ n = 8）, colon （ n = 6）, mesentery （ n = 1 ） and omentum （ n = 1 ）. The imaging and pathological features of GISTs were （ 1 ） most of GISTs were well-defined and exophytic （ n = 19, 73.1% ）, which usually compressed the adjacent tissues but no invasion. The tumor diameter ranged from 5.1 to 23.5 cm with a mean diameter of 11.6±5.9 era, （2）most tumors had an inhomogenous density or signal intensity due to necrosis（n =21, 80.8% ）, hemorrhage（n = 15, 57.7% ） or calcification （n = 3, 11.5% ） within the tumor, （3） on the CT or MR images, heterogeneous enhancement pattern presented as peripheral or intra-tumor patchy enhancement was common （n = 21, 80. 8% ）. Furthermore, enhanced striped vessels were seen in 12 patients. However, homogenous enhancement pattern was rare （ n = 5, 19.2% ）, （4） the most common site where GIST metastasized to was the liver （n =7）, followed by the peritoneum （n =4）, but rarely to lymph nodes, （5） of these 26 patients, spindle-cell type was observed in 69.2% （ n = 18）, epithelioid-cell type in 23.1% （n = 6）, and mixed cell type in 7.7% （n = 2）. Immunohistochemical studies showed positive CD117 expression in all of these 26 patients , but positive CD34 expression in only 22 patients. Conclusion Gastrointestinal stromal tumor usually presents as a exophytic, well-defined large tumor, with internal striped vessels, necrosis or hemorrhage within. It usually metastasizes to the liver or the peritoneum but rarely to lymph nodes. Pathologically, most of gastrointestinal stromal tumors consist of spindle-cells, while a small portion of the tumors are composed of epithelioid-cells or mixed ones. Both CT and MRI play an important role in the diagnosis of gastrointestinal stromal tumors.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2007年第5期386-390,共5页
Chinese Journal of Oncology
关键词
胃肠间质瘤
体层摄影
X线计算机
磁共振成像
病理学
Gastrointestinal stromal tumors
Tomography, X-ray computed
Magnetic resonance imaging
Pathology
