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Rofo 2004; 176(2): 183-190
DOI: 10.1055/s-2004-817631
Übersicht
© Georg Thieme Verlag Stuttgart · New York

Bildgebende Diagnostik von vaskulären Leiomyosarkomen

Diagnostic Imaging of Vascular LeiomyosarcomasB.  Kreft1 , S.  Flacke1 , H.  Zhou2 , J.  Textor1 , J.  Remig3 , H.  H.  Schild1
  • 1Radiologische Klinik
  • 2Pathologisches Institut
  • 3Chirurgische Klinik, Universität Bonn
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Publication History

Publication Date:
11 February 2004 (online)

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Zusammenfassung

Primäre vaskuläre Leiomyosarkome sind sehr seltene Tumoren, die venös meistens von der Vena cava inferior und arteriell von der Pulmonalarterie ausgehen. Die Tumoren zeigen entweder ein komplett extra- bzw. intravaskuläres oder ein gemischtes Wachstum. Die klinischen Symptome der venösen Tumoren richten sich nach der Lokalisation der Tumoren, wobei intraluminale Tumoren im Bereich der Vena cava inferior durch Ödeme oder ein Budd-Chiari-Syndrom auffallen können. Leiomyosarkome der Pulmonalarterien können chronische zentrale oder rezidivierende periphere Lungenembolie imitieren. Die kontrastverstärkte Spiral-CT mit multiplanaren Rekonstruktionen ist die diagnostische Methode der Wahl bei V. a. ein vaskuläres Leiomyosarkom, die durch die MRT in Kombination mit der MR-Angiographie ergänzt werden kann. Differenzialdiagnostisch sollte bei unklarer Organzugehörigkeit von Tumoren mit Kontakt zu Venen und/oder intraluminalem Anteil an die Möglichkeit eines primären vaskulären Leiomyosarkoms gedacht werden.

Abstract

Primary vascular leiomyosarcomas are very rare tumors, with the venous variety most often arising from the inferior caval vein and the arterial variety from the pulmonal artery. The tumors show either an exclusive intra- or extravascular pattern or a mixed growth pattern. The clinical symptoms depend on tumor location, with intraluminal tumors of the inferior caval vein causing edema or a Budd-Chiari syndrome. Leiomyosarcomas of the pulmonal artery can mimic chronic central or recurrent peripheral pulmonary embolism. Contrast enhanced spiral CT with multiplanar reconstruction is the diagnostic method of choice when a vascular leiomyosarcoma is suspected. MRI with MR-angiography can be added. If a tumor of undetermined origin shows a broad contact with a vessel and/or an intraluminal component, possible primary vascular leiomyosarcoma should be included in the differential diagnosis.

Key words

Vascular leiomyosarcoma - spiral CT - imaging - diagnosis

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Prof. Dr. med. Burkhard Kreft

Radiologische Klinik der Universität Bonn

Sigmund-Freud-Straße 25

53105 Bonn

Phone: + 49-228-2874852

Fax: + 49-228-2876093

Email: Kreft@ukb.uni-bonn.de

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