Koyama S, Araki M, Suzuki K, Fukutomi H, Maruyama T, Mun Y, Otsuka M, Fukao K
Department of Internal Medicine, University of Tsukuba, Ibaraki, Japan.
J Gastroenterol. 1996 Apr;31(2):268-72. doi: 10.1007/BF02389529.
A rare case of benign diaphragmatic schwannoma in a 38-year-old female is reported. Precontrast computed tomography (CT) showed an encapsulated well-defined round homogeneous tumor with central calcification, measuring approximately 5 cm in diameter, arising from the left diaphragm. Contrast-enhanced CT and gadolinium-enhanced T1-weighted magnetic resonance (MR) imaging showed focal enhancement in the central portion of the tumor. The tumor showed a typical target appearance of increased peripheral signal intensity and decreased central signal intensity on unenhanced T2-weighted images. Pathological examination of resected specimens of the tumor showed two zonal histological components: a hypercellular portion of spindle cells with nuclear palisading (Antoni A tissue) and a hypocellular portion of cells with cystic degeneration, together with focal calcification and hemangeomatous vascular changes (Antoni B tissue). We consider the radiological characteristics of diaphragmatic schwannoma on CT and MR imagings to represent the geographic difference between the histologic zones of the tumor.
报告了一例38岁女性的罕见良性膈肌神经鞘瘤病例。平扫计算机断层扫描（CT）显示一个边界清晰的包膜完整的圆形均匀肿瘤，中央有钙化，直径约5厘米，起源于左膈肌。增强CT和钆增强T1加权磁共振（MR）成像显示肿瘤中央部分有局灶性强化。在未增强的T2加权图像上，肿瘤呈现典型的靶征，外周信号强度增加而中央信号强度降低。对肿瘤切除标本的病理检查显示有两个区域的组织学成分：一个是梭形细胞的高细胞区，细胞核呈栅栏状排列（Antoni A组织），另一个是细胞呈囊性变的低细胞区，伴有局灶性钙化和血管瘤样血管改变（Antoni B组织）。我们认为CT和MR成像上膈肌神经鞘瘤的影像学特征代表了肿瘤组织学区域之间的结构差异。
