膀胱炎性肌纤维母细胞瘤的影像表现及临床分析
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Bladder inflammatory myofibroblastic tumor imaging findings and clinical analysis
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    目的:探讨膀胱炎性肌纤维母细胞瘤(inflammatory myofibroblastic tumor,IMT)的临床表现-影像特征-病理特点及治疗方法,提高对本病的认识-方法:对南京医科大学附属无锡市人民医院手术病理证实的5例膀胱IMT患者的CT-MR 表现及临床资料进行系统性分析,并结合文献进行总结-结果:临床表现为血尿-尿痛等症状;CT平扫呈均匀或不均匀肿块,MRI平扫T1WI为等低信号,T2WI为略高信号,增强扫描延迟期肿块实质部分呈持续性明显强化;镜下所见梭形细胞增生,编织状或者排列紊乱,伴有混合性炎细胞浸润,背景可呈黏液样;免疫组化Vim-SMA-MSA多阳性,Actin-HHF-35-Des部分阳性,Kertin-EmA-S-100均为阴性;5例均通过手术切除-结论:膀胱IMT临床症状与恶性肿瘤相似,影像学表现有一定特征性,确诊主要依靠病理及免疫组化,治疗方法以膀胱部分切除或经尿道切除为主-

    Abstract:

    Objective:To study the urinary bladder inflammatory myofibroblastic tumor (IMT) of the clinical manifestations,imaging features,pathological features and treatment methods to improve the understanding of this disease. Methods:From 5 pathologically confirmed cases of bladder IMT,CT,MR manifestations and clinical data of patients were systematically analyzed,and the summary of the literatures about IMT were done. Results:Clinical manifestations were hematuria,dysuria and other symptoms;CT scan showed homogeneous or heterogeneous tumors. T1WI of MRI showed low signal,and T2WI image showed slightly higher signal. Substantial part of the mass enhanced constantly under enhanced CT scan. Under microscope observation,spindle cells proliferated accompanied by mixed inflammatory cells infiltration with myxoid background.The expressions of Vim,SMA and MSA were mostly positive by immunohistochemistry method,while expressions of Actin,HHF-35 and Des were partial positive,and expressions of Kertin,EmA and S-100 were negative. Total 5 patients underwent surgical resection eventually. Conclusion:The clinical symptoms of IMT were similar to bladder cancer, and the image of IMT has characteristic manifestations. The diagnosis mainly depends on the pathological and immunohistochemical methods,and the treatment based on partial cystectomy or transurethral resection.

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钱 斌,鲍 健,陈宏伟,邹新农.膀胱炎性肌纤维母细胞瘤的影像表现及临床分析[J].南京医科大学学报(自然科学版),2011,(2):256-259

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  • 收稿日期:2010-08-04
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