Baidu
map

经阴道超声诊断阴道平滑肌瘤1例

2020-05-29 傅丽玲 何菲 李耀华 临床超声医学杂志

患者女,39岁,孕2产2,因发现阴道前壁肿物7月余就诊。妇科检查:于阴道前壁偏右侧可触及一大小约1.9 cm×1.3 cm肿物,质硬,光滑,活动度好,边界清,无压痛。经阴道超声检查:于阴道

患者女,39岁,孕2产2,因发现阴道前壁肿物7月余就诊。妇科检查:于阴道前壁偏右侧可触及一大小约1.9 cm×1.3 cm肿物,质硬,光滑,活动度好,边界清,无压痛。经阴道超声检查:于阴道前壁见一大小约1.8 cm×1.0 cm团状低回声,呈椭圆形,边界清,内部回声欠均匀;CDFI示肿块周边可见丰富的环状血流信号,其内可见较丰富血流信号(图1),阻力指数0.59。超声提示:阴道前壁实性结节,考虑阴道平滑肌瘤可能。遂行手术治疗,术后病理证实为阴道壁平滑肌瘤(图2)。


图1 CDFI示瘤体周边见丰富的环状血流信号


图2 阴道平滑肌瘤病理图(HE染色,×40)

讨论

阴道平滑肌瘤是临床上较罕见的阴道良性肿瘤,主要来源于阴道的血管平滑肌、竖毛肌、黏膜下平滑肌及圆韧带的平滑肌。目前认为其发病原因可能与激素长期刺激导致局部组织病理性过度增生有关,与子宫肌瘤的发生有一定关系。

本病好发于育龄期妇女,多为单发,常位于阴道前壁,其临床表现取决于肌瘤的大小和生长部位。本病病理学特征表现与子宫平滑肌瘤相似,有发生变性或恶变的可能,其超声表现亦可呈相应的实性低回声、无回声或囊实混合回声。

本例超声表现为椭圆形低回声结节,边界清,内回声欠均匀,周边可探及环状血流信号,血流阻力指数0.59,与子宫平滑肌瘤的超声特征相似,故考虑为平滑肌瘤,提示在行经阴道超声检查时应注意缓慢推进,多切面扫查,注意阴道壁上的病变,同时提高对本病的认识,以降低漏误诊率。本病需与阴道血管瘤、纤维瘤等良恶性肿瘤鉴别。

目前,超声、CT、MRI均为常见的辅助检查方法,但均无法明确诊断,其确诊主要依靠病理学检查。超声检查虽在术前无法确定肿物性质,但能帮助临床明确其范围、位置及其与邻近组织的关系,同时对术后治疗效果的判断和随访具有重要意义。

原始出处:

傅丽玲,何菲,李耀华.经阴道超声诊断阴道平滑肌瘤1例[J].临床超声医学杂志,2019(02):148.

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (4)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1691729, encodeId=b3091691e2954, content=<a href='/topic/show?id=8ed9488e37e' target=_blank style='color:#2F92EE;'>#平滑肌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48873, encryptionId=8ed9488e37e, topicName=平滑肌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a5d29283334, createdName=shijzhiewnjhch, createdTime=Sun Dec 20 16:22:00 CST 2020, time=2020-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1543106, encodeId=1d1e1543106f3, content=<a href='/topic/show?id=8702488e671' target=_blank style='color:#2F92EE;'>#平滑肌瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48876, encryptionId=8702488e671, topicName=平滑肌瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=719013532033, createdName=ms306040998833292, createdTime=Sun May 31 04:22:00 CST 2020, time=2020-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1560023, encodeId=4e7915600231b, content=<a href='/topic/show?id=c1eb9282699' target=_blank style='color:#2F92EE;'>#超声诊断#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92826, encryptionId=c1eb9282699, topicName=超声诊断)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6ebf15056071, createdName=tcm104hq, createdTime=Sun May 31 04:22:00 CST 2020, time=2020-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1566032, encodeId=994c156603224, content=<a href='/topic/show?id=c1eb9282699' target=_blank style='color:#2F92EE;'>#超声诊断#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92826, encryptionId=c1eb9282699, topicName=超声诊断)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6ebf15056071, createdName=tcm104hq, createdTime=Sun May 31 04:22:00 CST 2020, time=2020-05-31, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1691729, encodeId=b3091691e2954, content=<a href='/topic/show?id=8ed9488e37e' target=_blank style='color:#2F92EE;'>#平滑肌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48873, encryptionId=8ed9488e37e, topicName=平滑肌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a5d29283334, createdName=shijzhiewnjhch, createdTime=Sun Dec 20 16:22:00 CST 2020, time=2020-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1543106, encodeId=1d1e1543106f3, content=<a href='/topic/show?id=8702488e671' target=_blank style='color:#2F92EE;'>#平滑肌瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48876, encryptionId=8702488e671, topicName=平滑肌瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=719013532033, createdName=ms306040998833292, createdTime=Sun May 31 04:22:00 CST 2020, time=2020-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1560023, encodeId=4e7915600231b, content=<a href='/topic/show?id=c1eb9282699' target=_blank style='color:#2F92EE;'>#超声诊断#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92826, encryptionId=c1eb9282699, topicName=超声诊断)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6ebf15056071, createdName=tcm104hq, createdTime=Sun May 31 04:22:00 CST 2020, time=2020-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1566032, encodeId=994c156603224, content=<a href='/topic/show?id=c1eb9282699' target=_blank style='color:#2F92EE;'>#超声诊断#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92826, encryptionId=c1eb9282699, topicName=超声诊断)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6ebf15056071, createdName=tcm104hq, createdTime=Sun May 31 04:22:00 CST 2020, time=2020-05-31, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1691729, encodeId=b3091691e2954, content=<a href='/topic/show?id=8ed9488e37e' target=_blank style='color:#2F92EE;'>#平滑肌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48873, encryptionId=8ed9488e37e, topicName=平滑肌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a5d29283334, createdName=shijzhiewnjhch, createdTime=Sun Dec 20 16:22:00 CST 2020, time=2020-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1543106, encodeId=1d1e1543106f3, content=<a href='/topic/show?id=8702488e671' target=_blank style='color:#2F92EE;'>#平滑肌瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48876, encryptionId=8702488e671, topicName=平滑肌瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=719013532033, createdName=ms306040998833292, createdTime=Sun May 31 04:22:00 CST 2020, time=2020-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1560023, encodeId=4e7915600231b, content=<a href='/topic/show?id=c1eb9282699' target=_blank style='color:#2F92EE;'>#超声诊断#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92826, encryptionId=c1eb9282699, topicName=超声诊断)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6ebf15056071, createdName=tcm104hq, createdTime=Sun May 31 04:22:00 CST 2020, time=2020-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1566032, encodeId=994c156603224, content=<a href='/topic/show?id=c1eb9282699' target=_blank style='color:#2F92EE;'>#超声诊断#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92826, encryptionId=c1eb9282699, topicName=超声诊断)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6ebf15056071, createdName=tcm104hq, createdTime=Sun May 31 04:22:00 CST 2020, time=2020-05-31, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1691729, encodeId=b3091691e2954, content=<a href='/topic/show?id=8ed9488e37e' target=_blank style='color:#2F92EE;'>#平滑肌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48873, encryptionId=8ed9488e37e, topicName=平滑肌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a5d29283334, createdName=shijzhiewnjhch, createdTime=Sun Dec 20 16:22:00 CST 2020, time=2020-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1543106, encodeId=1d1e1543106f3, content=<a href='/topic/show?id=8702488e671' target=_blank style='color:#2F92EE;'>#平滑肌瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48876, encryptionId=8702488e671, topicName=平滑肌瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=719013532033, createdName=ms306040998833292, createdTime=Sun May 31 04:22:00 CST 2020, time=2020-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1560023, encodeId=4e7915600231b, content=<a href='/topic/show?id=c1eb9282699' target=_blank style='color:#2F92EE;'>#超声诊断#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92826, encryptionId=c1eb9282699, topicName=超声诊断)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6ebf15056071, createdName=tcm104hq, createdTime=Sun May 31 04:22:00 CST 2020, time=2020-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1566032, encodeId=994c156603224, content=<a href='/topic/show?id=c1eb9282699' target=_blank style='color:#2F92EE;'>#超声诊断#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92826, encryptionId=c1eb9282699, topicName=超声诊断)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6ebf15056071, createdName=tcm104hq, createdTime=Sun May 31 04:22:00 CST 2020, time=2020-05-31, status=1, ipAttribution=)]
Baidu
map
Baidu
map
Baidu
map