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目的:探讨膀胱炎性肌纤维母细胞瘤(inflammatory myofibroblastic tumor,IMT)的临床表现、影像特征、病理特点及治疗方法,提高对本病的认识。方法:对南京医科大学附属无锡市人民医院手术病理证实的5例膀胱IMT患者的CT、MR表现及临床资料进行系统性分析,并结合文献进行总结。结果:临床表现为血尿、尿痛等症状;CT平扫呈均匀或不均匀肿块,MRI平扫T1WI为等低信号,T2WI为略高信号,增强扫描延迟期肿块实质部分呈持续性明显强化;镜下所见梭形细胞增生,编织状或者排列紊乱,伴有混合性炎细胞浸润,背景可呈黏液样;免疫组化Vim、SMA、MSA多阳性,Actin、HHF-35、Des部分阳性,Kertin、E-mA、S-100均为阴性;5例均通过手术切除。结论:膀胱IMT临床症状与恶性肿瘤相似,影像学表现有一定特征性,确诊主要依靠病理及免疫组化,治疗方法以膀胱部分切除或经尿道切除为主。
Objective: To investigate the clinical manifestations, imaging features, pathological features and treatment of inflammatory myofibroblastic tumor (IMT) and to improve the understanding of this disease. Methods: CT and MR findings and clinical data of 5 cases of bladder IMT confirmed by surgery and pathology in Wuxi People ’s Hospital Affiliated to Nanjing Medical University were systematically analyzed and combined with the literature. Results: The clinical manifestations were hematuria, dysuria and other symptoms. The CT scan showed homogeneous or uneven mass. The MRI scan T1WI was the same signal, the T2WI was slightly higher signal, and the enhancement of the scan was delayed. Microscopically, the spindle cells were hyperplasia, weaved or disordered, accompanied by mixed inflammatory cell infiltration. The background was mucoid. The immunohistochemical Vim, SMA, MSA positive, Actin, HHF-35 and Des partially positive, Kertin, E-mA, S-100 were negative; 5 cases were surgically removed. Conclusions: The clinical manifestations of bladder IMT are similar to those of malignant tumors. The imaging findings have certain characteristics. The diagnosis mainly depends on the pathology and immunohistochemistry. The treatment of partial bladder resection or transurethral resection is the main treatment.