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[鼻窦嗜酸性细胞乳头状瘤的临床及影像学特征]

[Clinical and imaging features of sinonasal oncocytic papilloma].

作者信息

Sun Yan, Huang Qian, Cui Shunjiu, Wang Mingjie, Yang Bentao, Liu Honggang, Chen Xiaohong, Qu Jing, Zhou Bing

机构信息

Department of Otolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University,Beijing,100730,China.

Department of Radiology,Beijing Tongren Hospital,Capital Medical University.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Aug;35(8):688-693. doi: 10.13201/j.issn.2096-7993.2021.08.004.

Abstract

To analysze the clinical and imaging features of sinonasal oncocytic papilloma(SNOP). The clinical data of 31 cases of SNOP confirmed by pathology from May 2006 to September 2020 were retrospectively analyzed. The common sites of the tumor, clinical symptoms, imaging features and follow-up results were analyzed. Among the 31 patients, the common clinical symptoms were nasalobstructionand running nose. All the lesions were unilateral. The origin of the tumors was maxillary sinus in 17 cases, ethmoid sinus in 7 cases, frontal sinus in 4 cases, and sphenoid sinus in 3 cases. CT findings: 12 cases(38.7%) had hyperosteogeny or destruction, of which 3 cases(9.7%) showed focal osteitis. MRI findings: 25 cases(92.6%) showed "cerebriform" sign on T2WI or enhanced T1WI; 19 patients(70.4%) showed high or isointense signal on T1WI; 17 cases(63.0%) were associated with multiple cystoid changes. All patients were pathologically confirmed as SNOP, including 1 case with focal moderate to severe dysplasia and 1 case with carcinogenesis in situ. With follow-up 5 to 177 months, 1 case recurred, and the recurrence rate was 3.2%. The clinical symptoms of SNOP lack specificity and could be accompanied by polyps. The maxillary sinuses are most often involved, but other sinuses may also be affected. Nasal endoscopy and imaging examination have certain characteristics. The root pedicle of the tumor was mostly broad-based, with certain recurrence rate and malignant degeneration. Therefore, a reasonable surgical method should be selected to completely resect the lesion and reduce the recurrence.

摘要

分析鼻窦嗜酸性细胞乳头状瘤(SNOP)的临床及影像学特征。回顾性分析2006年5月至2020年9月间经病理确诊的31例SNOP患者的临床资料。分析肿瘤的常见部位、临床症状、影像学特征及随访结果。31例患者中,常见临床症状为鼻塞和流涕。所有病变均为单侧。肿瘤起源于上颌窦17例,筛窦7例,额窦4例,蝶窦3例。CT表现:12例(38.7%)有骨质增生或破坏,其中3例(9.7%)表现为局灶性骨炎。MRI表现:25例(92.6%)在T2WI或增强T1WI上表现为“脑回样”征;19例(70.4%)在T1WI上表现为高信号或等信号;17例(63.0%)伴有多发囊样改变。所有患者经病理确诊为SNOP,其中1例有局灶性中度至重度发育异常,1例原位癌变。随访5至177个月,1例复发,复发率为3.2%。SNOP的临床症状缺乏特异性,可伴有息肉。上颌窦最常受累,但其他鼻窦也可能受累。鼻内镜及影像学检查有一定特点。肿瘤根蒂多为宽基底,有一定复发率及恶变率。因此,应选择合理的手术方式,完整切除病变,降低复发率。

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