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中华胃肠内镜电子杂志 ›› 2021, Vol. 08 ›› Issue (01) : 24 -28. doi: 10.3877/cma.j.issn.2095-7157.2021.01.004

所属专题: 文献

论著

阑尾低级别黏液性肿瘤的CT及内镜诊断价值
彭春艳1, 汤蓓1, 王慧1, 张玮1, 沈珊珊1, 吕瑛1,()   
  1. 1. 210008 南京大学医学院附属鼓楼医院消化内科
  • 收稿日期:2020-06-08 出版日期:2021-02-15
  • 通信作者: 吕瑛
  • 基金资助:
    国家自然科学基金(62006113)

The diagnostic value of CT and endoscopy in low-grade appendiceal mucinous neoplasms confined to the appendix

Chunyan Peng1, Bei Tang1, Hui Wang1, Wei Zhang1, Shanshan Shen1, Ying Lv1,()   

  1. 1. Department of Gastroenterology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China
  • Received:2020-06-08 Published:2021-02-15
  • Corresponding author: Ying Lv
引用本文:

彭春艳, 汤蓓, 王慧, 张玮, 沈珊珊, 吕瑛. 阑尾低级别黏液性肿瘤的CT及内镜诊断价值[J]. 中华胃肠内镜电子杂志, 2021, 08(01): 24-28.

Chunyan Peng, Bei Tang, Hui Wang, Wei Zhang, Shanshan Shen, Ying Lv. The diagnostic value of CT and endoscopy in low-grade appendiceal mucinous neoplasms confined to the appendix[J]. Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition), 2021, 08(01): 24-28.

目的

探讨阑尾低级别黏液性肿瘤的CT及内镜特征。

方法

收集2014年1月至2019年12月南京大学医学院附属鼓楼医院收治且经外科手术病理证实的阑尾低级别黏液性肿瘤患者15例。回顾分析所有患者的临床、CT及内镜资料。

结果

所有患者均行CT和肠镜检查,CT下测量的病变直径中位数为5.8(2.5~11.0)cm,病变可见囊壁且边界清楚,增强CT显示病变囊壁轻度环状强化。内镜下可见阑尾开口部见圆形隆起性改变,大部分表面光滑。8例患者行超声内镜(EUS)检查,表现为阑尾窝开口处可见类圆形混合回声病变,边界清,呈清晰的"洋葱皮"回声特征。所有患者接受外科手术(7例行单纯阑尾切除术、8例行右半结肠切除术)。

结论

阑尾低级别黏液性肿瘤术前准确诊断仍具有挑战性,EUS下的"洋葱皮"样回声特征具有一定诊断价值。

Objective

To investigate the features of CT and endoscopy in Low-grade appendiceal mucinous neoplasms confined to the appendix (LAMNs).

Methods

Fifteen cases with histologically proven LAMNs confined to the appendix were included in this study from January 2014 to December 2019. Clinical data, and the characteristics of CT and endoscopy examinations were retrospectively analyzed.

Results

All patients had received CT and endoscopy examinations before surgery. In CT images, the median size is 5.8 (2.5-11.0) cm. All tumors had well-circumscribed margins. In enhanced CT images, early mild ring mural enhancement of the cystic wall was observed. The endoscopy examinations showed a round mass protruding from the appendiceal orifice, with normal overlying mucosa in most cases. Eight cases received EUS examinations, which showed an "onion skin" sign. All cases were treated with surgery, including 7 cases undergoing appendectomy and 8 receiving right hemicolectomy.

Conclusions

Although preoperative diagnosis of LAMNs confined to the appendix remains challenging, LAMNs should be considered when the "onion skin" sign is detected on EUS.

图1 阑尾低级别黏液性肿瘤的CT表现
图2 阑尾低级别黏液性肿瘤的内镜表现
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