弥漫型腱鞘巨细胞瘤的影像诊断和文献复习

目的：分析弥漫型腱鞘巨细胞瘤（D-GCTTS）的临床、病理、影像诊断和鉴别诊断特点，提高对D-GCTTS的认识。材料与方法：收集2例经病理证实的D-GCTTS患者的临床、影像、手术及病理资料。术前均进行X线平片、CT平扫、MRI平扫和增强扫描。分析D-GCTTS的临床和影像特征。结果：两例患者无特征性临床表现。X线平片骨质及关节间隙正常，仅见关节周围软组织肿胀。CT平扫：关节周围不规则均匀等密度肿块，边缘清楚；与邻近骨质关系密切，但没有明显的骨质破坏。MRI扫描各序列均以低信号为主，其中以T2WI信号最低，增强扫描肿块呈中等程度的不规则强化。手术所见：关节旁棕褐色肿物，包膜不完整，边界清楚，与关节囊和韧带紧密相连。镜下见类滑膜细胞的单核组织细胞、多核巨细胞和炎症细胞，泡沫细胞和含铁血黄素颗粒沉积。结论：MRI对于D-GCTTS的诊断具有极高的敏感性和特异性。

Imaging diagnosis and literature review of diffuse giant cell tumor of tendon sheath

Objective: To review clinical,pathological and imaging features of diffuse giant cell tumor of tendon sheath(D-GCTTS) and to elevate recognization for this rare benign tumor. Materials and Methods: To analyse the clinical,pathological and imaging data from two patients with pathologically confirmed D-GCTTS,who underwent the preoperative CR,CT and MRI plain-scan and enhanced-scan. Results: Radiographic examination showed no bony and joint abnormality,iso-dense mass in the soft tissue. CT scan showed an increased attenuation multilobular mass with clear margin; there were no bony destruction except sclerotic cortex and small cysts were found in the irregularly thickening cortex. MRI showed that the lesions have the similar low-signal intensities in the different sequences,specifically on T2WI. Within the removed specimen,there were two well-encapsulated solid elastic brownish masses,with high cellularity feartures consisting of synovial-like mononuclear mesenchymal cell,multinucleate giant cells,a few foam cells,hemosiderin desposition and inflammatory cells. Conculsion: MRI is a high sensitive and specific examination for diagnosis of D-GCTTS.