颅内粒细胞肉瘤诊断并文献复习

目的探讨粒细胞肉瘤的临床、病理及影像特点,以提高对粒细胞肉瘤的认识。方法回顾性分析1例经手术病理证实的颅内粒细胞肉瘤病人的临床、影像及病理资料,并复习相关文献。结果 MRI上左侧中颅窝可见一等T1稍长T_2信号肿物,边界清晰。T_2WI上病灶周边较中心信号略高,冠状面示肿物以宽基地与颅底相连,邻近颅底骨质局部信号略显增高,相邻脑皮质向脑内推移,脑沟变浅,并可见小片状长T_2水肿信号,同侧中耳乳突腔内可见蜂窝状长T_2信号。液体衰减反转恢复(FLAIR)序列上肿物呈稍高信号。DWI上明显扩散受限。ADC图上信号明显减低。增强后,肿物明显强化,且周边较中心强化略明显,矢状面及冠状面肿物基底部邻近硬膜可见"脑膜尾征"。结论粒细胞肉瘤的影像表现存在一定的特点,但不能作为诊断的特异性标志,最终诊断需要结合临床白血病病史及病理组织学检查。

Diagnosis of granulocytic sarcoma in intracranial attached literature review

Objebtive To discuss the clinical, pathological and radiological characteristics of granulocyte sarcoma, and improve the diagnosis efficiency of granulocyte sarcoma. Method The clinical, imaging and pathological data of one case intracranial granulocyte sarcoma patient who was confirmed by pathologywere retrospectively analyzed, and the relevant literatures were reviewed. Result MRI showed in the left middle cranial fossa there is one mass who showedisosignal on T₁WI and slightly high signal on T₂WI with defined border.The signal of lesions edge is slightly higher than its center on T₂WI sequences.On T₂WI coronary,the mass connected to the base of skull with broader base.Near the skull bone local signal slightly increased, the surrounding brain parenchyma was compressed and displaced. The sulci becomes shallow, high signal which is lamellaron T₂WI can be seen, in the ipsilateral mastoid of the middle ear, high signal which is honeycomb on T₂WI can be seen. Mass showed slightly higher signal on the FLAIR sequence. DWI sequence showed the dispersion is limited obviously. On ADC figure,signal reduced obviously.In the enhanced scanning, the tumor was enhanced significantly, and the enhanced degree of the lesions edgeis more obvious than its center.On sagittal and coronary, the“meningeal tail” can be seen in the base of the mass which is adjacent with the dura mater. Conclusion The imaging findings of granulocyte sarcoma has certain characteristics, but not as a diagnostic specificity,the final diagnosis depends on the clinical history of leukemia and histologic examination.