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一例阑尾杯状细胞腺癌误诊淋巴瘤:CT影像表现及文献复习
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Abstract:
阑尾杯状细胞腺癌(GCA)是一种罕见的阑尾恶性肿瘤,其临床上缺乏特异性症状和阳性体征,通常主要表现为急性阑尾炎、慢性腹痛或完全无症状,所以误诊及漏诊率极高。肿瘤通常发生在阑尾的远端,由于阑尾位置变异,可能出现在腹腔不同部位,表现为管壁增厚或肿块,但有时在CT上可能仅表现为阑尾近端的软组织密度,远端肿大和积液。其确诊主要依赖术中所见及术后病理检查。手术切除是其主要治疗手段,CT能够清楚地显示肿瘤的大小、部位及浸润程度等,因此对术前准确诊断具有极其重要的指导意义。本文通过回顾性分析本院一例经术后病理诊断的阑尾杯状细胞腺癌资料,并对国内外相关文献回顾复习、探讨其影像学表现特征,以提高阑尾癌的术前影像诊断水平,减少其诊断的误诊率。
Appendiceal goblet cell adenocarcinoma (GCA) is a rare malignant tumor of the appendix, which clinically lacks specific symptoms and positive signs, and is usually manifested as acute appendicitis, chronic abdominal pain, or completely asymptomatic, hence the rate of misdiagnosis and missed diagnosis is extremely high. The tumor usually occurs in the distal part of the appendix, and due to the variation in the location of the appendix, it may appear in different parts of the abdominal cavity, presenting as thickening of the wall or a mass, but sometimes on CT it may only appear as soft tissue density in the proximal part of the appendix, with distention and fluid accumulation in the distal part. The diagnosis mainly depends on intraoperative findings and postoperative pathological examination. Surgical resection is the main treatment method, and the resection mainly depends on the size, location, and degree of infiltration of the tumor, so preoperative accurate diagnosis has very important guiding significance. This article reviews the data of one case of appendiceal goblet cell adenocarcinoma diagnosed by postoperative pathology in our hospital, and reviews and discusses the imaging characteristics of related literature at home and abroad, in order to improve the preoperative imaging diagnosis level of appendiceal cancer and reduce the misdiagnosis rate.
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