目的: 探讨成人原发性横纹肌肉瘤(rhabdomyosarcoma,RMS)患者的临床及影像学特征。方法: 回顾性分析4例经手术病理证实的成人原发性RMS患者的临床资料和影像学表现。结果: 4例患者中,病变位于头颈部2例,位于盆腔1例,位于纵隔1例。所有患者均因相应部位肿胀或压迫症状就诊。CT显示病灶为软组织密度肿块,密度欠均匀,周围组织受压推移或侵犯;增强后病灶呈明显不均匀强化,4例患者的病灶内均可见坏死,但未见钙化成分。MRI检查T1WI图像上可见病灶呈等信号,T2WI图像上则以稍高信号为主;增强后呈不均匀持续强化。4例患者的病理组织行免疫组织化学染色,结果肌细胞生成素(Myogenin)均(+),波形蛋白(Vimentin)均(+),1例患者结蛋白Desmin(+)。结论: 成人原发性RMS罕见,其在CT及MRI图像上具有一定特征性,结合患者的临床表现进行分析,可提高诊断的准确率。
Objective: To investigate the clinicopathological characteristics, CT and MRI findings of primary rhabdomyosarcoma(RMS)in adults. Methods: Four adult patients with pathologically confirmed RMS admitted to Xinhua Hospital from 2012 to 2016 were enrolled. Results: Two patients had lesions located in head and neck, the other two in anterior chest wall and in pelvic cavity, respectively. RMS tended to be a heterogeneous soft-tissue mass with compression or invasion to surrounding tissue on non-enhanced CT image, which showed heterogeneous enhancement even with strong contrast enhancement in contrast-enhanced CT image. No fat and calcification components were found in all the 4 cases. MR imaging appearance of rhabdomyosarcoma was isointense or minimally hyperintensity in relative to muscle on T1-weighted images and hyperintensity on T2-weighted images. Conclusions: Adult primary rhabdomyosarcoma is rare, which has certain characteristic findings on CT and MRI image. Combined findings on imaging and clinical manifestations, the accuracy of diagnosis could be improved.
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