Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, 7/F, 2nd Building, 58# Zhongshan Road 2, Guangzhou, 510080, People's Republic of China.
Department of Pathology, The First Affiliated Hospital of Sun Yat-Sen University, NO.58 Zhongshan Road 2, Guangzhou, 510080, People's Republic of China.
BMC Med Imaging. 2020 May 3;20(1):46. doi: 10.1186/s12880-020-00447-6.
Large cell neuroendocrine carcinoma (LCNEC) of the urinary bladder is an uncommon malignant bladder tumor, and the overall prognosis is poor. Contrast-enhanced ultrasound (CEUS) provides a new effective modality for tumor detection and diagnosis.
A 30-year-old man complained of repeated painless gross haematuria for half a month. Conventional ultrasound demonstrated a hypoechoic solitary lesion with hyperechoic margins measuring 3.4 × 3.1 cm in the anterior wall of the bladder. Superb microvascular imaging (SMI) showed a strong flow signal in the mass. CEUS revealed that the lesion was characterized by hyper-enhancement in the early phase and hypo-enhancement in the late phase. The entire bladder wall was disrupted by homogeneous hyper-enhanced tumor tissue on CEUS. Time-intensity curves (TICs) showed a rapid wash-in with a high maximum signal intensity (SI) and quick wash-out. Finally, partial cystectomy was performed and the pathological examination confirmed the diagnosis of LCNEC with invasion into the whole layer of the bladder wall.
This case suggested that CEUS was a valuable imaging method to detect and diagnose LCNEC in the bladder, and that CEUS can provide information related to the depth of wall invasion and the microvasculature.
膀胱大细胞神经内分泌癌（LCNEC）是一种罕见的恶性膀胱肿瘤，整体预后较差。增强超声（CEUS）为肿瘤的检测和诊断提供了一种新的有效方式。
一名 30 岁男性因反复无痛肉眼血尿半个月就诊。常规超声显示膀胱前壁有一个边界回声增强的低回声单发肿物，大小为 3.4×3.1cm。超声造影显示肿块内有强烈的血流信号。CEUS 显示病变在早期呈高增强，晚期呈低增强。整个膀胱壁被均匀的高增强肿瘤组织破坏。时间-强度曲线（TIC）显示快速的灌注，具有高最大信号强度（SI）和快速洗脱。最后，行部分膀胱切除术，病理检查证实诊断为 LCNEC，侵犯整个膀胱壁全层。
该病例提示 CEUS 是一种有价值的检测和诊断膀胱 LCNEC 的影像学方法，CEUS 可以提供与壁浸润深度和微血管相关的信息。
