食管癌肉瘤X线诊断(附7例报告)

目的：探讨食管癌肉瘤的Ｘ线诊断。材料和方法：经手术病理证实的食管癌肉瘤７例，男５例，女２例。全部病例均行食管低张双对比造影检查。结果：根据Ｘ线表现将７例食管癌肉瘤分成息肉型和浸润型。息肉型６例，表现为腔内带蒂或宽基的肿物，呈分叶状，瘤基底周围的食管粘膜不规则破坏，呈颗粒状隆起或钡点。浸润型１例，表现为管腔狭窄、管壁僵硬、粘膜破坏，可见腔内外软组织肿块。食管癌肉瘤中癌全部为鳞癌、肉瘤中２例平滑肌肉瘤、４例纤维间质细胞肉瘤、１例恶性纤维组织细胞瘤。结论：具有上述Ｘ线表现，结合患者年龄偏大，症状相对较轻，应考虑食管癌肉瘤。

The X Ray Diagnosis of Esophageal Carcinosarcoma (A Report of 7 Cases)

Purpose: To discuss the x ray diagnosis of esophageal carcinosarcoma. Materials and Methods: Seven cases (5 male, 2 female) of esophageal carcinosarcoma found by double contrast roentgenography and proved by pathologic examination were reported. Results: Cases in our group were classified in polypoid type (6 cases) and infiltrating type (1 case). The polypoid tumor appeared as intraluminally situated mass with smooth surface but lobulated contour and destruction of the surrounding mucosal folds. The infiltrating growth presented as narrowing of various degrees of esophageal lumen with stiffness of esophageal wall and destruction of mucosa, and sometimes soft tissue mass can be detected intraluminally and extraluminally. The carcinomatous components of the tumor were all squamous cell carcinoma, while the sarcomatous components were leiomyosarcoma (2 cases), fibrous mesenchymal cell sarcoma (4 cases), malignant fibrous histiocytoma (1 case), respectively. Conclusion: Esophageal carcinosarcoma should be considered as differential diagnosis if esophageal roentgenogram showed intraluminal polypoid mass with smooth suface, with or without lobulated margin, and with pedunculated or broad base attached to the esophageal wall.