肌肉原发髓外浆细胞瘤的影像学表现及鉴别诊断

目的探讨分析原发于肌肉组织的髓外浆细胞瘤的CT及MRI表现、鉴别诊断,提高对该病的认识。方法收集经病理证实的肌肉原发髓外浆细胞瘤3例,对其影像学及鉴别诊断进行回顾性分析和总结。结果(1)发生部位:左侧竖脊肌1例,右侧闭孔内外肌1例,左股部肌肉1例;(2)肿块大小:最大径约26.4cm,最小径约4.7cm;(3)肿块边缘:较清晰;(4)密度或信号:CT密度或MRI信号较均匀,与临近肌肉类似,增强扫描中度强化,DWI呈明显高信号,ADC-map呈明显低信号改变;(5)临近组织改变:周围肌间隙受压或消失,临近骨质呈溶骨性骨质破坏。结论肌肉原发髓外浆细胞瘤CT、MRI表现有一定特点,能够明确显示病变范围及周围骨骼受侵情况,但确诊尚需病理学检查。

Image Features and Differential Diagnosis of Extramedullary Plasmacytoma of Muscle

Objective To investigate the imaging features of CT/MRI differential diagnosis of extramedullary plasmacytoma primary in muscle,improving awareness of it.Methods cases of primary extramedullary plasmacytoma of muscle confirmed by pathology were collected,the imaging and diffe rential diagnosis were retrospectively analyzed and summarized.Results(1)Occurre nce site:a case of left erector spinal,a case of right obturator medial and extra obturator muscles,a case of left thigh muscles;(2)Mass size:the maximum diameter is about 26.4 cm,the shortest path is about4.7 cm.(3)Margin of mass:it is clear;(4)Density or signal density:CT density or MRI signal density is more uniform,similar to adjacent muscles,Moderate enhancement on the enhanced scan,DWI showed high signal intensity,ADC-map showed significantly low signal;(5)Adjacent tissue changes:compression or disappearance of peripheral muscle space,the adjacent bone showed osteolytic destruction.Conclusion CT and MRI findings of primary extramedullary plasmacytoma in skeletal muscle have certain characteristics,it can clearly show the extent of the lesion and the surrounding bone damage,but the diagnosis still needs pathological examination.