摘要
目的 探讨不典型肠癌的病理基础及CT诊断要点。材料与方法 搜集伴肠外囊性肿块形成的肠癌 11例 ,其中管状腺癌 6例 ,粘液腺癌 3例 ,管状腺癌伴粘液腺癌 2例。结果 主要CT表现为 :肠浆膜外囊性肿块 11例 ,肠壁局限性增厚 9例 ,肠腔内囊性肿块 2例。经与病理对照分析后提示肠外囊性肿块形成的原因有 :肠癌浆膜外直接浸润伴囊变坏死 6例 ,溃疡型肠癌慢性穿孔 3例 ,继发阑尾粘液囊肿 1例 ,另 1例粘液腺癌可能是结肠憩室或深在性的囊性结肠炎癌变所致。 11例中 10例由CT首诊 ,正确诊断 4例 ,误诊 6例 ,其中误诊为脓肿 4例 ,腹腔肿瘤 2例。误诊原因主要是缺乏对不典型肠癌CT表现的认识 ,忽略了癌性肠壁增厚特征等因素所致。结论 肠外囊性肿块形成是肠癌的不典型CT表现 ,易误诊。如注意观察肠壁增厚和肠腔内外肿块的形状 。
Objective To study the pathologic basis and diagnostic points of atypical intestinal carcinomas.Materials and Methods CT features and pathologic correlation of atypical intestinal carcinomas in 11 patients, including tubular adnocarcinoma (n=6), mucinous adenocarcinoma (n=3) and tubular mixed mucinous adenocarcinoma (n=2), were reported and analyzed.Results The main CT findings included extraluminal cystic mass (n=11), local bowel wall thickening (n=9) and intraluminal cystic mass (n=2). Pathologically, the extraluminal cystic mass was due to infiltration outside bowel wall (n=6), chronic perforation of ulcerative intestinal adenocarcinoma (n=3), secondary appendix mucinous cyst (n=1), and, possibly, due to cystic colitis or colonic diverticulosis (n=1). Of 11 cases, the diagnosis was made by CT on the initial medical visit in 10, 6 of which was proved to be misdiagnosed as simple abscess (n=4) or abdominal neoplasm (n=2). The main reasons for the misdiagnosis were due to the lack of the knowledge in the imaging features of the disease and due to paying little attention to the characteristic sign of bowel wall thickening.Conclusion Extraluminal cystic mass formation is an atypical CT sign of intestinal carcinoma, which can easily cause misdiagnosis. When great attention is paid to the sign of bowel wall thickening and to the shape of both the intra and extra luminal masses, qualitative diagnosis by CT will be significantly improved.
出处
《临床放射学杂志》
CSCD
北大核心
2001年第11期850-853,共4页
Journal of Clinical Radiology
关键词
肠肿瘤
腺癌
粘液腺癌
CT
诊断
病理
肠癌
Intestinal neoplasm Adenocarcinoma Mucinous adenocarcinoma Tomography, X ray computed
