Chen Si-Lu, Liu Gang, Cui Meng-Qiu, Yan Xiao-Bin
Department of Radiology, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, China.
Department of Radiology, The First Medical Center of Chinese PLA General Hospital, Beijing, China.
Ann Transl Med. 2022 Jan;10(1):27. doi: 10.21037/atm-21-6976.
We report a case of a well-defined lesion in an asymptomatic patient with lipomatous ganglioneuroma (LG) located close to the left thoracic spine. Its intensity was heterogeneous with adipocytes. The lesion extended into the spinal canal through the enlarged left intervertebral without bony erosion. The imaging, clinical, and pathological features of the tumor are analyzed. Contrast-enhanced magnetic resonance imaging (MRI) revealed that the lesion was moderate enhanced. 18-F-fluoro-2-deoxyglucose-positron emission tomography/computed tomography (18FDG-PET/CT) demonstrated high 18-F-fluoro-2-deoxyglucose (18FDG) uptake of the tumor lesion. The finial preoperative diagnosis from our radiologists was that the tumor may be a liposarcoma or neurogenic tumor, but pathology showed that this was incorrect. Some related literatures were reviewed for reference to summarize imaging characteristics of this disease and to assist radiologists in making more accurate diagnoses. All of the lesions had adipocytes in reviewed literature, and the fat-suppressed images showed that there was some low signal intensity within the lesions, some lesions had widened neural foramina and extended into the spinal canal, and some lesion had calcifications. LG is an extremely rare variant of ganglioneuroma. Using the correct measurement of the CT value, applying MRI for fat-suppressed images, using in phase, out phase and contrast-enhanced sequences, using FDG-PET/CT, mastering LG imaging diagnostics characteristics, and combining all of this with clinical, morphological characteristics and pathology results can help clinical workers decrease the misdiagnosis rate of LG.
我们报告一例无症状患者，其左胸段脊柱旁存在一个边界清晰的脂肪性神经节细胞瘤（LG）病变。该病变内脂肪细胞的信号强度不均。病变通过扩大的左侧椎间孔延伸至椎管内，无骨质侵蚀。对该肿瘤的影像学、临床及病理特征进行了分析。对比增强磁共振成像（MRI）显示病变呈中度强化。18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（18FDG-PET/CT）显示肿瘤病变对18F-氟脱氧葡萄糖（18FDG）摄取较高。我们的放射科医生术前最终诊断该肿瘤可能为脂肪肉瘤或神经源性肿瘤，但病理结果显示这一诊断有误。查阅了一些相关文献以供参考，以总结该疾病的影像学特征，协助放射科医生做出更准确的诊断。在查阅的文献中，所有病变均含有脂肪细胞，脂肪抑制图像显示病变内有一些低信号强度区，一些病变的椎间孔增宽并延伸至椎管内，一些病变有钙化。LG是神经节细胞瘤的一种极其罕见的变异型。正确测量CT值，应用MRI获取脂肪抑制图像，使用同相位、反相位及对比增强序列，使用FDG-PET/CT，掌握LG的影像学诊断特征，并将所有这些与临床、形态学特征及病理结果相结合，有助于临床工作者降低LG的误诊率。
