颈静脉孔区及鼓室内颈静脉球瘤1例并文献复习

摘要

Objective To investigate clinical manifestations, imaging and pathological features, and differential diagnosis of glomus jugulare and glomus tympanicum tumor. Methods The imaging and pathological data of 1 case confirmed by surgery and pathology of glomus jugulare and glomus tympanicum tumor was retrospectively analyzed and the related literature was reviewed. Results CT scan showed a large soft tissue mass in the left jugular foramen, middle ear, tympanic antrum, and mastoid cells combined with local mastoid destruction and the lesion protruding into the left external auditory canal. Cranial MRI showed a irregular strip mass in the left jugular foramenm, grew along the outside of the left jugular foramen prominent cranial and extended into the left parapharyngeal space, convex to the left tympanic and mastoid. Immunohistochemistry staining were positive for Syn,NSE,CD56,CD34,CgA, negative for CK, the ki-67 proliferation activity was low (<1%), which indicate paraganglioma. Conclusion The bone destruction of jugular foramen and tympanicum, obvious enhancement of the lesion,rapidly wash in and wash out of the dynamic curve support the diagnosis of the glomus jugulare and glomus tympanicum tumor. It is helpful to outline the range of the tumor combing CT and MRI.%目的：探讨颈静脉孔区及鼓室内颈静脉球瘤的临床表现、影像和病理特征及其鉴别诊断。方法回顾性分析1例经手术病理证实的颈静脉孔区及鼓室内颈静脉球瘤病人的影像及病理资料，并复习相关文献。结果CT检查示左侧颈静脉孔、中耳鼓室、鼓窦及乳突气房内可见软组织密度影，局部乳突骨质破坏，并突入左侧外耳道；颅底MRI示左侧颈静脉孔区不规则条状肿物，沿左侧颈静脉孔突出颅外，并伸入左侧咽旁间隙，凸向左侧中耳鼓室及乳突气房。术后病理诊断为副神经节瘤。免疫组织化学结果：Syn、NSE、CD56、CD34、CgA 阳性，CK阴性， ki-67增殖活性较低（<1%），提示副神经节瘤。结论颈静脉孔及鼓室骨质破坏以及病变明显强化和速升速降的动态曲线支持颈静脉球瘤和鼓室球瘤的诊断。联合CT和MRI能够明确病变的范围。