早读片2015-07-31女61岁PatientID：41721677主诉：体检发现左侧胸腔占位一月余入院情况：患者一月前因咳嗽地热于外院查体发现左侧胸腔占位。患者目前无明显不适，无胸闷憋气，无咳嗽咳痰，无胸痛。入院查体：左肺下叶呼吸音较对侧减弱。既往史：高血压十余年，药物控制满意。1971年急性阑尾炎，阑尾切除。肿瘤标记物：CA125：41.8U/ml（0-35.0）NSE(神经元特异性烯醇化酶):17.3ng/ml(0-16.3)ProGRP（血清胃泌素释放肽前体）:56.0pg/ml(0-50)诊断及鉴别诊断手术记录病理结果AsimilarcaseintheliteratureCTscanningoftheneckandchestdemonstratingthelipoidmassdisplacingthetrachea,theoesophagusandgreatvesselswithoutdirectinvasionBriefIntroductionClassification12Classification14Cross-sectionalimagingofwell-differentiatedliposarcomaisfrequentlycharacteristic.CTandMRimagingrevealalesioncomposedof>50to75%adiposetissuewithadditionalprominentnonlipomatouscomponents.Thenonlipomatouscomponentsofthelesioncommonlyrevealthick(>2mm)andnumerousseptaorfocalglobularornodularregions(typically<2cminsize).（collagenizedareas,metaplasticmineralization,fatnecrosis…）Well-differentiatedliposarcomaofthedistalthighina65-year-oldwoman.CT,sagittalT1-WI,andsagittalT2-WIMRimagesshowalargelylipomatoussofttissuemass(arrows)withprominentnonlipomatouscomponentsseenasirregularthickseptaeandglobularregions(arrowheads)typicalofwell-differentiatedliposarcoma.ForradiologistsBiopsyofextremitylesionsisoftenfraughtwithuncertainty,owingtothelargesizeandheterogeneityoftheselesionsandpossibilityofnotobtainingdiagnostictissuetoallowdifferentiationfromlipoma.Imagingmaybehelpfultodirectbiopsytomorenonlipomatousregions,allowingmoreconfidentpathologicaldiagnosis.DedifferentiatedLiposarcoma(DDLS)20ImagingfeaturesofDDLSCoronalT1WIandT2WIMRimagesrevealamasslargelycomposedoftissueisointensetosubcutaneousfat(arrows)butalsocontainingthickseptae(arrowheads).ThereisalsoalargenodularnonlipomatouscomponentwithnonspecificcharacteristicsoflowsignalintensityonT1WIandheterogeneousintermediatetohighsignalintensityonT2WI(asterisks).ForradiologistsLearningPoints早读片2015-09-11CasePresentation病理结果RetroperitonealLiposarcomaZhang,W.D.,etal.(2015)."Managementofretroperitonealliposarcoma:Acasereportandreviewoftheliterature.