原发性生殖腺外精原细胞瘤的MSCT表现分析

目的分析原发性生殖腺外精原细胞瘤的MSCT表现,并提高对该肿瘤的认识。资料与方法回顾性分析经病理证实的生殖腺外精原细胞瘤5例,总结和分析其临床及MSCT表现。5例均为男性,年龄28～67岁,平均45.8岁。前纵隔2例,腹膜后1例,盆腔1例,鞍区1例,均为单发。结果生殖腺外精原细胞瘤好发于青壮年,临床表现无特异性。2例位于纵隔者,病灶较小者,呈类椭圆形改变,边界清楚,有包膜。病灶较大者,呈分叶状改变,向周围浸润性生长,边界不清,病灶内可见斑片状低密度坏死区。腹膜后1例,密度不均,其内可见斑片状低密度坏死影,边界不清,包绕腹主动脉,并向周围呈浸润性生长。盆腔1例,呈椭圆形,边界清楚,包膜完整,其内可见低密度坏死影。位于鞍区者,其内可见多发斑点状及条片状钙化影。MSCT平扫肿瘤实性成分呈等密度或稍高密度影。4例行增强扫描,3例表现为明显不均匀强化,1例表现为均匀强化。结论原发性生殖腺外精原细胞瘤极为罕见,MSCT可清楚显示肿瘤形态、大小、强化方式以及向周边组织浸润的程度,但缺乏特异性,结合患者发病年龄、性别、部位等临床特点,可进一步提高对其术前诊断准确率,但确诊仍需依赖病理。

Multislice Spiral CT Features of Primary Seminoma of Extragonadal

Objective To analyze MSCT features of primary extragonadal seminoma and improve its diagnositic accuracy.Materials and Methods The clinical and MSCT findings of 5 patients with primary extragonadal seminoma proved by histopathology were analyzed retrospectively.5 cases were all males,aged 28 to 67,with an average age of 45.8.Two cases located in anterior mediastina,one located in retroperitoneal,one in pelvic cavity,one in saddle area.Each case showed single mass.Results Primary extragonadal seminoma usually occurred in the young or middle aged adults with no specific clinical manifestations.Two cases located in the anterior mediastina,the smaller one was oval like,the boundary was clear with capsule,the bigger one was shallow lobulated with central zone of necrosis and the boundary was not clear,infiltrating growth was found.One case located in retroperitoneal,which was lobulated with central zones of necrosis,infiltrating growth,and the abdominal aorta was circled.One in pelvic cavity was oval with capsule,the central necrosis was presented;One in saddle area,foci and strippled calcification was found.The solid part of lesion showed isodense or hyperdense on MSCT plan scan.4 cases received enhanced CT examinations,3 cases were enhanced heterogeneously,1 case was enhanced homogeneously.Conclusion Primary extragonadal seminoma is rare,MSCT is of great diagnostic and clinical values according to the configuration,size,density,its style of enhancement and surrounding infiltration of primary extragonadal seminoma.The accuracy of diagnosis of primary extragonadal seminoma depends on clinical,locaton,age and gender,the final diagnosis depends on pathology.