骨盆孤立性浆细胞瘤的临床及影像表现分析

目的分析骨盆孤立性浆细胞瘤的临床及影像表现特点。方法经手术病理证实的18例骨盆孤立性浆细胞瘤,16例行X线检查,7例行CT检查,14例行MRI检查。结果 (1)临床表现:男性10例,女性8例,发病年龄44-79岁,平均年龄60.1岁。(2)X线、CT表现:孤立性浆细胞瘤18例中,16例表现为溶骨性骨质破坏合并软组织肿块,2例为膨胀性骨质破坏,10例病灶内可见残存的硬化骨嵴及边缘出现硬化。(3)MRI表现为正常骨髓信号被肿瘤取代,10例形成信号相对均匀的软组织肿块,4例软组织肿块信号不均。T1WI上病灶表现为等信号6例、稍高信号8例,T2WI病灶均表现为高或稍高信号,10例瘤周存在水肿,增强扫描均明显强化。结论骨盆是骨孤立性浆细胞的少见部位,好发于老年患者,其影像表现具有一定特征性。

Clinical and Imaging Manifestation of Solitary Plasmacytoma in Pelvic Bones

Objective The objective was to characterize clinical manifestation and imaging findings of solitary plasmacytoma in pelvic bones.Methods Clinical and imaging data for solitary plasmacytoma of pelvic bones in 18 patients were reviewed retrospectively. Conventional radiographs (n=16), computed tomographic images (n=7), and magnetic resonance images (n=14) were reviewed. All the patients were stained with hematoxylin-eosin and microscopically examined.Results There were eight female and 10 male patients with an age range of 44 to 79 years (average age, 60.1 years). 16 cases showed the cortical disruption with soft tissue mass,the other two cases showed expansive destruction of bone.10 cases showed the cortical disruption with rim osteosclerosis and bony septations. All the cases that had MRI examination showed normal marrow being replaced by tumors and 10 cases had extra-osseous soft tissue mass. The affected bone marrow and soft tissue mass showed isointensity six cases and slightly hyperintensity eight cases relative to muscles. T2-weighted MR images revealed hyperintensity with peritumoral edema. Gadolinium-DTPA-enhanced T1-weighted MR images showed significant enhancement in 10 cases.Conclusion Solitary plasmacytoma in pelvic bones is rare, it mainly occurred in elderly patients.Solitary plasmacytoma in pelvis bones have characteristic images that it is important for its diagnosis and differential diagnosis.