Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia.
Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.
Ophthalmology. 2018 Apr;125(4):597-605. doi: 10.1016/j.ophtha.2017.09.029. Epub 2017 Nov 6.
The purpose of this study was to correlate magnetic resonance imaging (MRI) radiographic results with histopathologic growth patterns of metastatic uveal melanoma (UM) to the liver.
Clinicopathologic correlation.
Patients with metastatic UM to the liver.
A retrospective review of MRI images of patients with metastatic UM to the liver at a single institution between 2004 and 2016 was performed. The MRI growth patterns were classified as nodular or diffuse. The histopathologic findings of core liver biopsies of liver metastases identified by needle localization in a subset of these patients were reviewed. The core samples were evaluated by routine light microscopy, including immunohistochemical/immunofluorescent staining for CD31, CD105, and HMB45, and classified as exhibiting an infiltrative or nodular growth pattern.
Magnetic resonance images and core biopsy findings.
A total of 32 patients were identified with metastatic UM to the liver that was imaged by MRI, and 127 lesions were identified. A total of 46 lesions were classified by MRI as infiltrative and 81 as nodular. There were 9 needle-localized core biopsies that corresponded to MRI of metastatic lesions. Of these 9 lesions, 3 that were classified as infiltrative on MRI exhibited stage I infiltrative histologic growth patterns; of the remaining 6 that were classified as nodular by MRI, 5 histologically demonstrated stage II or stage III infiltrative growth patterns and 1 histologically demonstrated a nodular growth pattern.
Magnetic resonance imaging of hepatic infiltrative growth patterns of metastatic UM corresponded to stage I histologic infiltrative growth in the sinusoidal spaces, whereas MRI nodular growth patterns corresponded to stage II/III histologic infiltrative growth that replaced the hepatic lobule or histologic nodular growth in the portal triad that effaced adjacent hepatic parenchyma.
本研究旨在将磁共振成像（MRI）影像学结果与转移性葡萄膜黑色素瘤（UM）肝转移的组织病理学生长模式相关联。
临床病理相关性研究。
患有肝转移性 UM 的患者。
对 2004 年至 2016 年期间在一家机构接受肝转移性 UM 的 MRI 检查的患者进行了回顾性 MRI 图像审查。将 MRI 生长模式分为结节状或弥漫性。对其中一部分患者通过经皮肝穿刺活检定位的肝转移核心活检的组织病理学发现进行了回顾。通过常规光镜评估核心样本，包括 CD31、CD105 和 HMB45 的免疫组织化学/免疫荧光染色，并分类为浸润性或结节性生长模式。
磁共振成像和核心活检结果。
共确定了 32 例有肝转移 UM 的患者，并对其进行了 MRI 成像，共发现了 127 个病灶。MRI 共将 46 个病灶分类为浸润性，81 个为结节性。共有 9 个经皮肝穿刺活检定位的核心活检与转移性病变的 MRI 相对应。在这 9 个病变中，有 3 个在 MRI 上分类为浸润性的病变表现为 I 期浸润性组织学生长模式；在其余 6 个在 MRI 上分类为结节性的病变中，有 5 个组织学表现为 II 期或 III 期浸润性生长模式，1 个组织学表现为结节性生长模式。
肝转移性 UM 的 MRI 浸润性生长模式与窦状隙的 I 期组织学浸润性生长相对应，而 MRI 结节性生长模式与替代肝小叶或门静脉三联区的组织学浸润性生长相对应，这些生长模式会使邻近的肝实质消失。
