基础医学与临床 ›› 2012, Vol. 32 ›› Issue (4): 442-446.

• 研究论文 • 上一篇    下一篇

继发于恶性肿瘤的腹膜后纤维化临床和影像学特征分析

孙瓅贤,冷晓梅,孔芳,陈净,牟利军   

  1. 中国医学科学院 北京协和医学院 北京协和医院
  • 收稿日期:2011-12-05 修回日期:2012-02-22 出版日期:2012-04-05 发布日期:2012-03-21
  • 通讯作者: 冷晓梅 E-mail:Lengxm@gmail.com

The Clinical Findings and Imaging Features of Retroperitoneal Fibrosis Secondary to Malignant Neoplasmas

  • Received:2011-12-05 Revised:2012-02-22 Online:2012-04-05 Published:2012-03-21

摘要: 摘要: 目的 探讨继发于恶性肿瘤的腹膜后纤维化(RPF, Retroperitoneal Fibrosis)的临床和影像学特征。 方法 分析我院1992年7月~2010年1月各科住院的RPF患者共106例,以其中继发于恶性肿瘤的8例RPF为研究对象,收集患者的临床资料并进行规律随访。 结果 8例恶性RPF中男性5例,女性3例,平均年龄59.6岁。原发肿瘤中生殖系统肿瘤4例,消化系统肿瘤2例,血液系统肿瘤及恶性神经鞘瘤各1例,其中1例同时患胃癌和膀胱癌。恶性RPF的临床症状与良性者比较并无特异,诊断主要依据影像学和病理。恶性RPF计算机X射线断层造影(CT)的特点:通常范围更广泛,肿物体积更大,包绕的腹主动脉、下腔静脉可发生背离脊柱方向的移位,输尿管可能发生向外侧移位;肿物边缘多呈结节或分叶状;肿物的中心多偏向髂血管方向。CT还可评价疗效和提示预后,病理学为最终确诊依据。 结论 恶性RPF临床症状无特异性,但影像学表现有一定特征,有鉴别诊断意义。

关键词: 腹膜后纤维化, 恶性肿瘤, 计算机X射线断层造影

Abstract: Abstract: Objective To analyze the clinical and imaging features of retroperitoneal fibrosis (RPF) secondary to malignant tumors. Methods We retrospectively analyzed 106 patients with retroperitoneal fibrosis from July 1992 to January 2010 in our hospital. Among them 8 cases with malignant tumors were consecutively enrolled in the study. The demographic and clinical data of the 8 patients were collected, and the follow-up was fulfilled regularly. Results We found that there were 5 male and 3 female among the patients, and the mean age was 59.6 years old. The primary neoplasms were from genital system (4 cases), digestive system (2 cases), hematological system (1 case) and malignant neurilemmoma (1 case). One case underwent both the stomach carcinoma and bladder cancer. The clinical symptoms of malignant RPF had no typical features compared to those of the benign RPF. However, the abdominal X-ray computed tomography (CT) exposed some important features which were special to the malignant RPF. If the RPF masses are very extensive, elevate aorta and ureter from spine, or have a lobulated anterior margin, which clue to the malignant diagnosis. In the meanwhile , the abdominal CT can evaluate the management effectiveness and prognosis. Definite diagnosis of the RPF mass depends on the pathology findings. Conclusion Familiarity with the imaging manifestations of retroperitoneal fibrosis is vital to differential diagnosis.

Key words: Retroperitoneal fibrosis, Malignant neoplasms, Computed Tomography, X-ray

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