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多参数磁共振成像发现转移至坐骨直肠窝淋巴结的前列腺癌。

Metastatic prostate cancer to an ischiorectal fossa lymph node identified on multiparametric magnetic resonance imaging.

作者信息

Fang Andrew M, Galgano Samuel J, Gordetsky Jennifer B, Sudarshan Sunil, McDonald Andrew M, Rais-Bahrami Soroush

机构信息

Department of Urology, University of Alabama at Birmingham, Birmingham, Alabama, USA.

Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama, USA.

出版信息

Urol Ann. 2020 Apr-Jun;12(2):172-175. doi: 10.4103/UA.UA_31_19. Epub 2020 Apr 14.

DOI:10.4103/UA.UA_31_19
PMID:32565657
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7292429/
Abstract

Prostate cancer is the most common noncutaneous malignancy in American men. Its lymphatic drainage is very well established throughout literature. We report the case of a 72-year-old Caucasian male with elevated serum prostate-specific antigen and biopsy-confirmed high-risk prostate cancer who underwent multiparametric magnetic resonance imaging (MRI) for staging and treatment planning. The imaging revealed suspicious lymph nodes in the left ischiorectal and right obturator fossae that were biopsy confirmed as metastatic prostate adenocarcinoma. Herein, we present the divergence from the well-established lymphatic drainage of prostate cancer and the role of MRI in detecting this prostate cancer site of spread.

摘要

前列腺癌是美国男性中最常见的非皮肤恶性肿瘤。其淋巴引流在文献中已有充分记载。我们报告一例72岁的白种男性，其血清前列腺特异性抗原升高，活检确诊为高危前列腺癌，接受了多参数磁共振成像（MRI）以进行分期和治疗规划。影像学检查发现左侧坐骨直肠窝和右侧闭孔窝有可疑淋巴结，活检证实为转移性前列腺腺癌。在此，我们展示了与前列腺癌既定淋巴引流的差异以及MRI在检测该前列腺癌转移部位中的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/533d/7292429/aa617c38d3ee/UA-12-172-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/533d/7292429/c3b3f0e1f809/UA-12-172-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/533d/7292429/2b4e5b8d1286/UA-12-172-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/533d/7292429/54c5b6ba0c16/UA-12-172-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/533d/7292429/9f1f0b713abc/UA-12-172-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/533d/7292429/aa617c38d3ee/UA-12-172-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/533d/7292429/c3b3f0e1f809/UA-12-172-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/533d/7292429/2b4e5b8d1286/UA-12-172-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/533d/7292429/54c5b6ba0c16/UA-12-172-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/533d/7292429/9f1f0b713abc/UA-12-172-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/533d/7292429/aa617c38d3ee/UA-12-172-g005.jpg

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本文引用的文献

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Preoperative multiparametric MRI of the prostate for the prediction of lymph node metastases in prostate cancer patients treated with extended pelvic lymph node dissection.前列腺癌患者行扩大盆腔淋巴结清扫术的前列腺术前多参数 MRI 预测淋巴结转移。
Eur Radiol. 2018 May;28(5):1969-1976. doi: 10.1007/s00330-017-5229-6. Epub 2017 Dec 21.
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Lymph node imaging in initial staging of prostate cancer: An overview and update.前列腺癌初始分期中的淋巴结成像：综述与更新
World J Radiol. 2017 Oct 28;9(10):389-399. doi: 10.4329/wjr.v9.i10.389.
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One-step TNM staging of high-risk prostate cancer using magnetic resonance imaging (MRI): toward an upfront simplified "all-in-one" imaging approach?
采用磁共振成像（MRI）对高危前列腺癌进行一步式 TNM 分期：是否朝着简化的“一站式”成像方法前进？
Prostate. 2014 May;74(5):469-77. doi: 10.1002/pros.22764. Epub 2013 Dec 24.
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Prospective comparison of computed tomography, diffusion-weighted magnetic resonance imaging and [11C]choline positron emission tomography/computed tomography for preoperative lymph node staging in prostate cancer patients.计算机断层扫描、扩散加权磁共振成像和[11C]胆碱正电子发射断层扫描/计算机断层扫描对前列腺癌患者术前淋巴结分期的前瞻性比较。
Eur J Nucl Med Mol Imaging. 2014 Apr;41(4):694-701. doi: 10.1007/s00259-013-2634-1. Epub 2013 Dec 3.
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Collision lymph node metastasis of rectal and prostate adenocarcinomas.直肠和前列腺腺癌的碰撞性淋巴结转移
Pathol Int. 2013 Aug;63(8):425-7. doi: 10.1111/pin.12084.
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Pelvic lymph node dissection during robot-assisted radical prostatectomy: efficacy, limitations, and complications-a systematic review of the literature.机器人辅助根治性前列腺切除术时的盆腔淋巴结清扫术：疗效、局限性和并发症——文献系统评价。
Eur Urol. 2014 Jan;65(1):7-16. doi: 10.1016/j.eururo.2013.03.057. Epub 2013 Apr 6.
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Lymphatic spread of nodal metastases in high-risk prostate cancer: The ascending pathway from the pelvis to the retroperitoneum.高危前列腺癌中淋巴结转移的淋巴扩散：从骨盆到腹膜后上行途径。
Prostate. 2012 Feb 1;72(2):186-92. doi: 10.1002/pros.21420. Epub 2011 May 2.
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Lymph node metastases of prostatic adenocarcinoma in the mesorectum in patients with rectal cancer.直肠癌患者直肠系膜中前列腺腺癌的淋巴结转移。
Cancer Res Treat. 2005 Apr;37(2):129-32. doi: 10.4143/crt.2005.37.2.129. Epub 2005 Apr 30.
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The diagnostic accuracy of CT and MRI in the staging of pelvic lymph nodes in patients with prostate cancer: a meta-analysis.CT和MRI对前列腺癌患者盆腔淋巴结分期的诊断准确性：一项荟萃分析。
Clin Radiol. 2008 Apr;63(4):387-95. doi: 10.1016/j.crad.2007.05.022. Epub 2008 Feb 4.
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