纵隔生殖细胞源性肿瘤的CT诊断和鉴别诊断(附32例报告)

目的总结纵隔生殖细胞源性肿瘤的CT表现及良、恶性的鉴别要点。方法回顾性分析32例经手术病理证实的纵隔生殖细胞源性肿瘤。结果32例中,良性生殖细胞源性肿瘤26例,其中囊性肿块10例,实性肿块9例,囊实性肿块7例;恶性生殖细胞源性肿瘤6例,其中精原细胞瘤、内胚窦(卵黄囊)瘤及胚胎细胞癌各1例和恶性畸胎瘤3例。典型的良性畸胎类肿瘤显示水样至软组织密度肿块,边缘清晰,其内有脂肪或钙化等,推移压迫周围组织,恶性肿瘤具有边缘分叶状或不规则,与周围组织脂肪间隙消失并侵犯相邻器官的征象。结论CT对纵隔良性生殖细胞源性肿瘤能准确作出诊断,纵隔恶性生殖细胞源性肿瘤难以与纵隔其它恶性肿瘤区分。

CT Diagnosis and Differential Diagnosis of the Tumors of Germ Cell Origin in the Mediastinum :A Report of 32 cases

Objective To summarize CT features , benign and malignant differential main points of the tumors of germ cell origin in the mediastinum.Methods 32 cases with pathologically confirmed the tumors of germ cell origin in the mediastinum were retrospectively analysed.Results Of 32 cases,26 were benign tumors,including cyst mass in 10,solid mass in 9 and cyst-solid mass in 7.6 cases were malignant tumors, including seminoma in 1 ,endodermal sinus tumor or yolk sac tumor in 1,embryo cell casinoma in 1 and malignant teratoma in 3 .Typical benign teratoid tumors appeared as water to soft tissue density masses,with defined margin,fat or calcification inside the tumors,around tissues were compresed by tumors,the malignant tumors appeared as lobular or irregular masses and around organ invaded.Conclusion CT is a reliable method for the diagnosis of the tumors of germ cell origin in the mediastinum accurately.Malignant tumors of germ cell origin in the mediastinum are difficult differentiation from other mediastinal malignant tumors.