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右耳高－中分化鳞状细胞癌CT病例！

2018-07-20 佚名 影像园

右耳高中分化鳞状细胞癌CT病例
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男，56岁，右耳反复流脓2年余，加重伴听力下降、疼痛2月，突发右侧周围性面瘫3周。

【病史临床】

男，56岁，右耳反复流脓2年余，加重伴听力下降、疼痛2月，突发右侧周围性面瘫3周。

【影像图片】


平扫A                              平扫B


增强D                              骨窗E


增强C


骨窗F

【影像表现】 

横断面平扫（A、B）示右侧外耳道、中耳区见软组织肿块影，大小约3．9×3．8cm；增强扫描（C、D）示肿块有强化，向前侵犯右侧颞骨鳞部，向外侵犯右侧腮腺，向内、后侵犯颞骨岩部、乳突；骨窗（E、F）示外耳道、中耳、乳突骨质不规则虫蚀状破坏。

【诊断】

右耳高－中分化鳞状细胞癌 （病理确诊）送检组织可见瘤细胞呈片巢状或团块状分布，细胞大小不一，细胞连接紧密，可见细胞间桥，胞浆红染，可见细胞内角化，细胞核形态不规则，胞核深染，核膜清晰，核仁明显。



【鉴别诊断】

胆脂瘤型中耳炎

【讨论】 

中耳癌（carcinoma of middle ear）占全身癌的0.06%，占耳部肿瘤的5%～10%。病理类型以鳞癌多见。临床表现早期症状少，易出血，可有脓性耳漏，耳内闷胀感、耳鸣与听力减退，因伴中耳炎常被忽视。

影像诊断要点及鉴别诊断：（1）高分辨率CT上能清楚显示外耳及中耳骨质结构不规则及多点虫蚀状破坏，破坏骨质无硬化边。（2）增强扫描强化明显，可与胆脂瘤相鉴别。

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#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1978720, encodeId=016019e872084, content=<a href='/topic/show?id=3b90e79787f' target=_blank style='color:#2F92EE;'>#细胞癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77978, encryptionId=3b90e79787f, topicName=细胞癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e457184, createdName=qingting, createdTime=Mon Nov 05 08:00:00 CST 2018, time=2018-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1783894, encodeId=977f1e838948e, content=<a href='/topic/show?id=947f54e23d' target=_blank style='color:#2F92EE;'>#CT病例#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5472, encryptionId=947f54e23d, topicName=CT病例)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Wed Jun 12 09:00:00 CST 2019, time=2019-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332929, encodeId=257333292931, content=学习了！！！！！！, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Fri Jul 20 15:43:44 CST 2018, time=2018-07-20, status=1, ipAttribution=)]
    2018-11-05 qingting

    #细胞癌#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1978720, encodeId=016019e872084, content=<a href='/topic/show?id=3b90e79787f' target=_blank style='color:#2F92EE;'>#细胞癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77978, encryptionId=3b90e79787f, topicName=细胞癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e457184, createdName=qingting, createdTime=Mon Nov 05 08:00:00 CST 2018, time=2018-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1783894, encodeId=977f1e838948e, content=<a href='/topic/show?id=947f54e23d' target=_blank style='color:#2F92EE;'>#CT病例#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5472, encryptionId=947f54e23d, topicName=CT病例)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Wed Jun 12 09:00:00 CST 2019, time=2019-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332929, encodeId=257333292931, content=学习了！！！！！！, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Fri Jul 20 15:43:44 CST 2018, time=2018-07-20, status=1, ipAttribution=)]
    2019-06-12 yinhl1978

    #CT病例#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1978720, encodeId=016019e872084, content=<a href='/topic/show?id=3b90e79787f' target=_blank style='color:#2F92EE;'>#细胞癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77978, encryptionId=3b90e79787f, topicName=细胞癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e457184, createdName=qingting, createdTime=Mon Nov 05 08:00:00 CST 2018, time=2018-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1783894, encodeId=977f1e838948e, content=<a href='/topic/show?id=947f54e23d' target=_blank style='color:#2F92EE;'>#CT病例#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5472, encryptionId=947f54e23d, topicName=CT病例)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Wed Jun 12 09:00:00 CST 2019, time=2019-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332929, encodeId=257333292931, content=学习了！！！！！！, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Fri Jul 20 15:43:44 CST 2018, time=2018-07-20, status=1, ipAttribution=)]
    2018-07-20 zb1235672

    学习了！！！！！！

    0