Dyrstad Sara W, Fowler Amy M, Jokerst Clint E, Baker Jonathan C, Hillen Travis J, Menias Christine
Mallinckrodt Institute of Radiology, St. Louis, MO.
Mallinckrodt Institute of Radiology, St. Louis, MO.
Curr Probl Diagn Radiol. 2014 Mar-Apr;43(2):68-79. doi: 10.1067/j.cpradiol.2013.11.001.
This article is a case-based review of the broad spectrum of tumors with musculoskeletal histology that can arise in the abdomen or pelvis and involve the soft tissues, muscle, and bone. In this article, pathology-proven cases are presented with a focus on radiographic, computed tomography, magnetic resonance imaging, and positron emission tomography-computed tomography findings. The imaging features that differentiate tumors with musculoskeletal histology from more common abdominal tumors are discussed. Representative cases include malignant fibrous histiocytoma, chondrosarcoma, Ewing sarcoma, hemangiopericytoma, desmoplastic fibroma, neurofibrosarcoma, osteosarcoma, intimal sarcoma, liposarcoma, leiomyosarcoma, synovial sarcoma, teratoma, and chordoma. A variety of tumors with musculoskeletal histology can arise in the abdomen and pelvis. In some cases, unique imaging characteristics allow a confident diagnosis, whereas other cases have a more nonspecific appearance. Recognition of imaging features that suggest a musculoskeletal tumor including direct extension from a bone or neural foramen, the presence of cartilaginous or osseous matrix, or macroscopic fat would allow the radiologist to suggest the proper diagnosis. Recognizing imaging characteristics of tumors with musculoskeletal histology is important clinically as management and prognosis differ from that of more common abdominal tumors.
本文是以病例为基础，对发生于腹部或骨盆、累及软组织、肌肉和骨骼、具有肌肉骨骼组织学特征的多种肿瘤进行的综述。本文呈现了经病理证实的病例，重点关注其X线、计算机断层扫描（CT）、磁共振成像（MRI）及正电子发射断层扫描-计算机断层扫描（PET-CT）表现。文中讨论了具有肌肉骨骼组织学特征的肿瘤与更常见腹部肿瘤在影像学上的鉴别特征。代表性病例包括恶性纤维组织细胞瘤、软骨肉瘤、尤因肉瘤、血管外皮细胞瘤、促纤维增生性纤维瘤、神经纤维肉瘤、骨肉瘤、内膜肉瘤、脂肪肉瘤、平滑肌肉瘤、滑膜肉瘤、畸胎瘤和脊索瘤。多种具有肌肉骨骼组织学特征的肿瘤可发生于腹部和骨盆。在某些情况下，独特的影像学特征可作出明确诊断，而在其他情况下，表现则更不具特异性。认识到提示肌肉骨骼肿瘤的影像学特征，包括从骨或神经孔直接蔓延、存在软骨或骨基质或肉眼可见的脂肪，将有助于放射科医生作出正确诊断。认识具有肌肉骨骼组织学特征肿瘤的影像学特征在临床上很重要，因为其治疗和预后与更常见的腹部肿瘤不同。
