胸腺内胚窦瘤的CT诊断

目的:探讨胸腺内胚窦瘤的CT表现。方法:回顾性分析8例经手术病理证实的胸腺内胚窦瘤患者的CT表现。主要观察内容包括病变位置、大小、内部结构、边界及与周围结构的关系等。结果:8例中病灶位于前上纵隔5例,前中纵隔2例,前下纵隔1例。最大截面直径<3cm者2例,3~5cm者2例,>5cm者4例。CT平扫示病灶内密度不均匀,可见片状坏死,增强后呈明显不均匀强化。所有病灶边界不清,其中2例病变与纵隔血管分界不清,脂肪间隙消失;1例病变推移纵隔血管,但血管没有明显变形;5例可见病变周围结构受侵犯,3例为血管受侵,表现为血管变形,其内并见软组织密度影,1例病变侵及邻近肺组织,1例侵犯前胸壁及胸骨。结论:胸腺内胚窦瘤的CT表现具有恶性肿瘤的特点但缺乏特异性,确诊有赖于病理学检查。

CT Manifestations of Thymic Endodermal sinus Tumor

Objective:To investigate the CT manifestations of thymic endodermal sinus tumor.Methods:A total of 8 cases with surgery and pathology proved thymic endodermal sinus tumor were collected and their CT findings including the location,size,intra-tumoral changes,margin and the relationship of tumor with adjacent structures were analyzed retrospectively.Results:Of these 8 cases,the location of tumors were within anterior upper mediastinum (n=5),anterior middle mediastinum (n=2),anterior lower mediastinum (n=1).The largest dimension of the tumor was <3cm (n=2),between 3~5cm (n=2) and >5cm (n=4).On CT plain scan,all lesions were heterogeneous in density with patchy necrosis.After contrast enhancement,all of the lesions had heterogeneous enhancement with ill-defined margin.Disappearance of the fat space between lesion and the adjacent vessels (n=2),obvious displacement of the adjacent blood vessels (n=1) could also be assessed.5 cases had peri-tumoral involvement including deformation and encasement of adjacent blood vessels indicating blood vessel involvement (n=3),involvement of adjacent lung (n=1) and involvement of anterior thoracic wall and sternum (n=1).Conclusion:The CT findings of thymic endodermal sinus tumor are consistent with that of malignant tumor,but lack of specificity.The final diagnosis should be relied on pathology examination.