Li Xinchun, Zhang Weidong, Song Ting, Sun Chongpeng, Shen Yuechun
Department of Radiology, The First Affiliated Hospital of Guangzhou Medical College, People's Republic of China.
Abdom Imaging. 2011 Oct;36(5):590-5. doi: 10.1007/s00261-010-9655-z.
We analyze the computed tomography (CT) findings of a peripheral primitive neuroectodermal tumor (pPNET) arising in the abdominopelvic cavity and to improve understanding of the CT images of the tumor.
Twelve cases of pPNET confirmed by histopathology were analyzed retrospectively. Image characteristics of CT scanning were analyzed and compared with the pathology of the tumors.
There were 8 males and 4 females with mean age of 34.5 years. Unenhanced CT images showed large heterogeneous and ill-defined or well-defined masses with multiple patchy hypodense areas. The average diameter was 9.8 cm (range 4.0-17.2 cm). Contrast-enhanced CT images showed variable heterogeneous contrast enhancement with multiple non-enhancement areas. 3 cases revealed metastasis and 4 cases invaded into adjacent organs. Pathology showed areas of degeneration and necrosis in all tumors. Cluster of differentiation 99 and neurone specific enolase were detected positive in 11 and 12 cases, respectively.
In conclusion, pPNET in the abdominopelvic cavity likely affects young adults with a slight male preponderance and tend to be large and aggressive. Although CT findings are nonspecific and variable, a large ill-defined or well-defined heterogeneous mass with multiple patchy hypodense areas reflecting their cystic degeneration and necrosis on pathology examination may suggest the diagnosis of pPNET.
我们分析了发生于腹盆腔的外周原始神经外胚层肿瘤（pPNET）的计算机断层扫描（CT）表现，以提高对该肿瘤CT图像的认识。
回顾性分析12例经组织病理学证实的pPNET病例。分析CT扫描的图像特征，并与肿瘤病理学结果进行比较。
男性8例，女性4例，平均年龄34.5岁。CT平扫显示为边界不清或清晰的、大小不等的混杂密度肿块，内见多发斑片状低密度区。平均直径9.8 cm（范围4.0 - 17.2 cm）。CT增强扫描显示不均匀强化，内见多发无强化区。3例出现转移，4例侵犯相邻器官。病理显示所有肿瘤均有变性坏死区域。11例检测到分化簇99阳性，12例检测到神经元特异性烯醇化酶阳性。
总之，腹盆腔pPNET可能好发于青壮年男性，肿瘤体积较大且具有侵袭性。虽然CT表现无特异性且多变，但平扫见边界不清或清晰的较大混杂密度肿块，内见多发斑片状低密度区，提示病理上存在囊性变及坏死，可能提示pPNET的诊断。
