肾上腺原始神经外胚层肿瘤的CT表现

摘要

目的 探讨肾上腺原始神经外胚层肿瘤(PNET)的CT表现,旨在提高对本病的认识.方法 回顾性分析7例经病理证实的肾上腺PNET的CT表现.结果 患者年龄24～63岁,平均(47.6±13.7)岁.女6例,男1例.左侧肾上腺4例,右侧肾上腺3例.临床表现:上腹部胀痛3例,腰背部疼痛不适2例,体检发现1例,发热1例.实验室及内分泌检查未见异常.术后4例复发,2例远处转移,随访期间6例死亡,1例健在.CT示肿瘤最大径约10.1～19.4 cm,椭圆形或分叶状,2例边界清楚,5例边界不清并累及邻近器官.平扫呈等或稍低密度,伴坏死、囊变,未见钙化.增强呈渐进性不均匀强化,内见多房间隔样改变及网格状强化.结论 肾上腺PNET的CT表现能提示诊断,确诊仍需病理学检查,CT能较准确描述肿瘤内部结构、毗邻关系及转移情况.%Objective To explore the CT manifestations of primitive neuroectodermal tumor (PNET) of adrenal gland,aiming to increase the cognition on this disease.Methods The CT manifestations of 7 patients who were pathologically diagnosed with adrenal gland PNET were analyzed retrospectively.Results The age of patients was 24-63 years old,with average age of (47.6±13.7) years,including 6 females and 1 male.Location of PNET:4 in left adrenal gland and 3 in right adrenal gland.Clinical manifestations:3 cases had upper abdominal distension,2 cases suffered from pain of waist and back,1 case was discovered in physical examination and another 1 had fever.No abnormality was found in laboratory and endocrinological examinations.After operation,4 cases had recurrence and 2 had distant metastasis.During follow-up,6 patients died and only 1 still alive.CT showed that the tumor,whose maximum diameter was 10.1-19.4 cm,was elliptic or lobulated in shape.The tumor was clear in boundary in 2 patients,but was unclear in boundary and involved adjacent organs in 5 patients.The plain scanning showed equidensity or slightly low density,complicated with necrosis and cystic lesions without calcification.The enhanced scanning suggested progressive uneven enhancement,with multiple interatrial septum-like changes and latticed enhancement inside.Conclusion CT manifestations of adrenal gland PNET can prompt the diagnosis,pathological examination is still required for confirmation.CT can accurately describe the internal structures,adjacent relationship and the metastasis of tumors.