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目的探讨少见纵隔恶性生殖细胞来源肿瘤的CT影像学特征。方法回顾性分析经病理证实的7例少见纵隔恶性生殖细胞来源肿瘤的CT表现。结果 7例肿块均位于前上纵隔,其中精原细胞瘤3例,卵黄囊瘤2例,胚胎性癌1例,混合性生殖细胞肿瘤(90%卵黄囊瘤,10%胚胎性癌)1例。CT表现为圆形或类圆形肿块,肿块内见不同程度囊变或坏死液化区,未见钙化及脂肪成分,边缘不规则与周围脂肪间隙消失并侵犯邻近组织器官等恶性肿瘤征象。3例精原细胞瘤以实性成分为主,强化较均匀,其中1例β-HCG轻度升高;2例卵黄囊瘤以囊性成分为主,实性成分相对少并呈明显不均匀强化,有延迟渐进性强化的特征,AFP显著升高。1例胚胎性癌实性成分呈轻度强化,囊性坏死区无强化。1例混合性生殖细胞肿瘤实性成分呈中度强化,其影像学表现取决于肿块内所含成分及所占比例有关。结论少见纵隔恶性生殖细胞来源肿瘤CT表现具有一定特征性,结合血清AFP及β-HCG有助于提高对该类疾病诊断的准确性。
Objective To investigate the CT imaging features of malignant germ cell-derived tumors of rare mediastinum. Methods The CT findings of 7 cases of malignant germ cell derived from the mediastinum were retrospectively analyzed. Results All the 7 cases were located in the anterior superior mediastinum, including 3 cases of seminoma, 2 cases of yolk sac tumor, 1 case of embryonal carcinoma, 1 case of mixed germ cell tumor (90% yolk sac tumor and 10% embryonal carcinoma) . CT showed a round or oval mass, cystic lesions see the varying degrees of necrosis or liquefaction area, no calcification and fat composition, irregular edges and the disappearance of the surrounding fat gap and violations of adjacent tissue and other malignant tumor signs. 3 cases of seminoma with solid ingredients, the more uniform, of which 1 cases of β-HCG increased slightly; 2 cases of yolk sac tumor mainly cystic components, relatively few solid ingredients and was significantly uneven Fortified, with the characteristics of delayed progressive enhancement, AFP increased significantly. One case of embryonic carcinoma showed mild enhancement of solid composition, no enhancement of cystic necrosis area. One case of mixed germ cell tumors with moderate enhancement of the solid composition, the imaging performance depends on the mass contained within the composition and the proportion of. Conclusion CT findings of malignant germ cell originated from rare media have certain characteristics. Combining serum AFP and β-HCG can improve the diagnostic accuracy of this kind of disease.