阴囊内腺瘤样瘤超声表现及误诊分析
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摘要
目的观察阴囊内腺瘤样瘤的声像图表现,并分析超声误诊原因。方法回顾性分析15例经手术病理证实的阴囊内腺瘤样瘤患者的术前超声资料,并与病理结果对照,分析其超声表现及误诊原因。结果 15例阴囊内腺瘤样瘤中,8例位于附睾尾部,5例位于附睾头部,2例位于睾丸;3例超声误诊为炎性改变,3例误诊为囊肿,2例误诊为恶性肿瘤,7例未定性。超声表现为实性(12例)或囊性(3例)肿块。实性肿块中,7例边界清晰、形态规则,5例边界欠清晰;其中6例内部回声均匀,6例内部回声欠均匀,可见无回声及点状强回声。囊性肿块均为多囊,其内可见分隔。15例中,8例可探及血流信号,7例未见明显血流信号。结论阴囊内腺瘤样瘤的超声表现缺乏特异性,结合病史及其他影像学手段有助于减少误诊。
Objective To investigate the sonographic features and to analyze misdiagnosis causes of intrascrotal adenomatoid tumors.Methods Preoperative sonographic data of 15 patients confirmed as intrascrotal adenomatoid tumor by surgery and pathology were retrospectively analyzed.Compared with pathological results,the sonographic features and the misdiagnosis causes were analyzed.Results Among 15 patients,the tumors located at the tail of epididymis in 8 patients,at the head of epididymis in 5 patients and within the testis in 2 patients.The lesions were misdiagnosed as inflammatory diseases in 3 patients,as cysts in 3 and as malignant tumors in 2 patients,while in the others were indeterminate.Solid tumors were detected with ultrasound in 12 patients,while cystica in 3 patients.Among 12 patients with solid tumors,lesions in 7 patients had clear boundary and regular shape,while the boundary in the rest 5 patients were less clear.The internal echo was homogeneous in 6 patients and inhomogeneous in the rest 6 patients with echoless and punctate hyperecho.Cystic mass was characterized by polycystic with isolation belt.Among 15 patients of intrascrotal adenomatoid tumor,detectable blood flow signals were found in 8 patients,while no obvious blood flow signals were found in the rest 7 patients.Conclusion Ultrasonic features of intrascrotal adenomatoid tumor were less characteristic.Combination of clinical information and other imaging findings might help to decrease misdiagnosis.
Objective To investigate the sonographic features and to analyze misdiagnosis causes of intrascrotal adenomatoid tumors.Methods Preoperative sonographic data of 15 patients confirmed as intrascrotal adenomatoid tumor by surgery and pathology were retrospectively analyzed.Compared with pathological results,the sonographic features and the misdiagnosis causes were analyzed.Results Among 15 patients,the tumors located at the tail of epididymis in 8 patients,at the head of epididymis in 5 patients and within the testis in 2 patients.The lesions were misdiagnosed as inflammatory diseases in 3 patients,as cysts in 3 and as malignant tumors in 2 patients,while in the others were indeterminate.Solid tumors were detected with ultrasound in 12 patients,while cystica in 3 patients.Among 12 patients with solid tumors,lesions in 7 patients had clear boundary and regular shape,while the boundary in the rest 5 patients were less clear.The internal echo was homogeneous in 6 patients and inhomogeneous in the rest 6 patients with echoless and punctate hyperecho.Cystic mass was characterized by polycystic with isolation belt.Among 15 patients of intrascrotal adenomatoid tumor,detectable blood flow signals were found in 8 patients,while no obvious blood flow signals were found in the rest 7 patients.Conclusion Ultrasonic features of intrascrotal adenomatoid tumor were less characteristic.Combination of clinical information and other imaging findings might help to decrease misdiagnosis.
引文
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[6]林文金,薛恩生,俞丽云,等.阴囊内腺瘤样瘤的超声表现.中华超声影像学杂志,2015,24(11):992-995.
[7]Amin W,Parwani AV.Adenomatoid tumor of testis.Clin Med Pathol,2009,2:17-22.
[8]Sun AY,Polackwich AS,Sabanegh ES Jr.Adenomatoid tumor of the testis arising from the tunica albuginea.Rev Urol,2016,18(1):51-53.
[9]Di Pierro PG,Sciarra A,Innocenzi M,et al.Rare case of multiple adenomatoid tumors arising from tunica vaginalis of testis and epididymis.Actas Urol Esp,2010,34(6):560-561.
[10]张惠,邓立强,向素芳.附睾腺瘤样瘤高频彩色多普勒超声与超声造影表现.四川医学,2015,36(12):1747-1749.
[11]陈顺平,胡元平,陈漫宇,等.附睾腺瘤样瘤的超声诊断价值.中国医师杂志,2010,12(12):1691-1692.
[12]Guo K,Tian R,Liu L,et al.Adenomatoid tumor of the tunica albuginea in a boy:A case report and literature review.Case Rep Urol,2015,2015:935193.
[13]朱小刚,阮小燕,李礼,等.附睾乳头状囊腺瘤超声表现.中国超声医学杂志,2015,31(12):1140-1142.
[14]李志强,崔立刚,陈文,等.阴囊内腺瘤样瘤的声像图表现.中国超声医学杂志,2013,29(11):1047-1049.
[15]丁高峰,张盛敏.实时超声弹性成像诊断睾丸良恶性病变的价值.现代实用医学,2014,26(5):627-628.
[2]Alexiev BA,Xu LF,Heath JE,et al.Adenomatoid tumor of the testis with intratesticular growth:A case report and review of the literature.Int J Surg Pathol,2011,19(6):838-842.
[3]Patoulias I,Kaselas C,Patoulias D,et al.Epididymal adenomatoid tumor:A very rare paratesticular tumor of childhood.Case Rep Med,2016,2016:9539378.
[4]Smart JM,Jackson EK,Redman SL,et al.Ultrasound findings of masses of the paratesticular space.Clin Radiol,2008,63(8):929-938.
[5]李萌,龚兰.附睾腺瘤样瘤超声表现1例.临床超声医学杂志,2017,19(5):328.
[6]林文金,薛恩生,俞丽云,等.阴囊内腺瘤样瘤的超声表现.中华超声影像学杂志,2015,24(11):992-995.
[7]Amin W,Parwani AV.Adenomatoid tumor of testis.Clin Med Pathol,2009,2:17-22.
[8]Sun AY,Polackwich AS,Sabanegh ES Jr.Adenomatoid tumor of the testis arising from the tunica albuginea.Rev Urol,2016,18(1):51-53.
[9]Di Pierro PG,Sciarra A,Innocenzi M,et al.Rare case of multiple adenomatoid tumors arising from tunica vaginalis of testis and epididymis.Actas Urol Esp,2010,34(6):560-561.
[10]张惠,邓立强,向素芳.附睾腺瘤样瘤高频彩色多普勒超声与超声造影表现.四川医学,2015,36(12):1747-1749.
[11]陈顺平,胡元平,陈漫宇,等.附睾腺瘤样瘤的超声诊断价值.中国医师杂志,2010,12(12):1691-1692.
[12]Guo K,Tian R,Liu L,et al.Adenomatoid tumor of the tunica albuginea in a boy:A case report and literature review.Case Rep Urol,2015,2015:935193.
[13]朱小刚,阮小燕,李礼,等.附睾乳头状囊腺瘤超声表现.中国超声医学杂志,2015,31(12):1140-1142.
[14]李志强,崔立刚,陈文,等.阴囊内腺瘤样瘤的声像图表现.中国超声医学杂志,2013,29(11):1047-1049.
[15]丁高峰,张盛敏.实时超声弹性成像诊断睾丸良恶性病变的价值.现代实用医学,2014,26(5):627-628.