Göğüs duvarı yumuşak doku kitleleri BT bulguları

Özet

Göğüs duvarını tutan hastalıklar arasında enfeksiyöz ve inflamatuvar tablolar ile tümörler bulunur. BT, kitlenin cilt altı yağ, kas, interkostal aralık, kaburga, plevra veya akciğerden hangisiyle merkezlendiğini ve kalsifikasyon, yağ ya da nekroz içerip içermediğini gösterir. Desmoid tümörlerde MR, yumuşak doku karakterizasyonunda tercih edilen görüntüleme yöntemidir ve üstün karakterizasyon sağlar. Göğüs duvarı tümörlerinde görüntüleme, lezyon yayılımının değerlendirilmesi ve evreleme ile tedavi planlamasında rol oynar.

Faz ve pencere

Kontrastsız tanısal: BT’de kitledeki kalsifikasyon ve komşu kemik korteksi değerlendirilebilir; kronik genişleyen hematomlar düşük atenüasyonlu, septalı, karışık yumuşak doku yoğunluklu ve periferik kapsülü kontrastlanan kitleler olarak görülebilir.
Venöz tanısal: Kontrastlı toraks serisinde kitlenin solid kısmının kontrastlanması, nekrotik veya sıvı alanların kontrastlanmaması, damarlarla komşuluğu ve plevra-akciğer uzanımı incelenir; tek başına kontrastlanma paterni histolojik tanı koydurmaz.

Önerilen pencereler: Yumuşak doku (G 400 / M 40), Kemik (G 1800 / M 400), Akciğer (G 1500 / M -600).

BT bulguları

Kitlenin merkezi cilt altı yağda, pektoralis veya interkostal kasta ya da kaburga boyunca yer alır; multiplanar devamlılık kökeni daraltır.
Makroskopik yağ içeren, ince kapsüllü ve homojen lezyon lipom lehinedir; kalın septa veya nodüler yumuşak doku bileşenleri atipik lipomatöz tümör olasılığını artırır.
Solid yumuşak doku kitlesinin düzensiz konturu, heterojen kontrastlanması ve nekrotik alanları agresif neoplazi veya enfeksiyon açısından kuşku doğurur, ancak özgül değildir.
Kaburgada düzgün kortikal çentiklenme yavaş bası etkisini; permeatif yıkım, kortikal kesinti veya eşlik eden yumuşak doku kitlesi invaziv kemik tutulumunu düşündürür.
Plevra tabanlı bir kitle akciğer parankimini komprese edebilir ve göğüs duvarına uzanabilir.
Kontrastlanan damar yapıları veya tümör içi belirgin damarlar biyopsi öncesi damar ilişkisini tarif etmeyi gerektirir.
Travma, cerrahi, biyopsi veya antitrombotik tedavi sonrası hematom gelişebilir; kronik genişleyen hematomlar büyüyerek maligniteyi taklit edebilir ve solid kontrastlanan bileşen gösterebilir.

Normalde

Şüpheli tarafta karşı tarafın aynı seviyedeki kas kalınlığı ve yağ planlarıyla kıyas yap; kaburga korteksinin düzgünlüğünü, ekstraplevral yağın devamlılığını ve akciğer-plevra sınırını takip et.

Normal BT ile kıyasla

Aynı bölgenin, kaynak veri setinde patoloji içermediği belirtilen bir BT incelemesini kesit kesit kaydırın; organ sınırlarını açarak anatomiyi hasta görüntüsüyle karşılaştırın. Küçük rastlantısal bulgular tümüyle dışlanmamıştır.

Kaynak: TotalSegmentator v2.01 veri seti (Wasserthal ve ark., Radiology: Artificial Intelligence 2023), CC BY 4.0, vaka s1278; organ sınırları veri setinin otomatik segmentasyonundan, birleştirilerek sadeleştirildi. Görüntüler 2,5 mm kesit aralığına yeniden örneklendi.

Ayırıcı tanı

Lipom: makroskopik yağ atenüasyonu baskındır; kalın septa veya nodüler solid parça bulunmaması benign lipom lehinedir.
Hematom: travma, girişim veya antikoagülasyon bağlamında kan ürünleri ve çevresel ödem görülür; zaman içindeki küçülme tanıyı destekler.
Göğüs duvarı apsesi: sıvı merkezi çevresel kontrastlanabilir; komşu ciltte inflamasyon, yağ dokuda kirlenme veya plevral enfeksiyon eşlik edebilir.
Kaburga kaynaklı tümör: kitle kemik medullasından dışarı büyür ve korteksi genişletir ya da yıkar.
Plevral tümör: lezyon plevra boyunca plak veya nodül biçiminde uzanır; kas merkezli kitleye göre göğüs duvarı kas planlarını ikincil olarak iter.
Akciğer tümörünün göğüs duvarı invazyonu: parankimal kitle ile plevral sınır kaybolur, kaburga veya interkostal kas tutulumu eşlik edebilir.

Tuzaklar

Kontrastlanmayan merkez nekroz, kistik bileşen veya hematom olabilir; çevredeki canlı solid dokuyu ve klinik bağlamı birlikte tarif et.
Düzgün kaburga çentiği bası remodeling'i olabilir; kırık veya tümöral yıkım için kortikal süreklilik ve medüller görünümü kemik penceresinde izle.

Kendini dene

Bilinen kanseri olan bir hastada kontrastlı BT’de göğüs duvarı nodülleri ve sternum yıkımına eşlik eden yumuşak doku kitleleri görülüyor. Bu görünüm hangi olasılığı destekler?
Cevabı göster
Göğüs duvarı metastatik tutulumu. Kaynak olguda kontrastlanan göğüs duvarı nodülleri metastatik tümörleri düşündürmüş; sternum yıkımı ve eşlik eden yumuşak doku kitleleri metastazla ilişkilendirilmiştir.
Kronik genişleyen hematomların BT görünümünde aşağıdakilerden hangisi görülebilir?
Cevabı göster
Karışık yumuşak doku yoğunluğu ve periferik kapsül kontrastlanması. Kronik genişleyen hematomlar BT’de düşük atenüasyonlu, iyi sınırlı kitleler olarak görülebilir; iç septalar, karışık yumuşak doku yoğunluğu veya periferik kapsül kontrastlanması eşlik edebilir.

İlgili konular

Kaynaklar

Bu sayfadaki 33 cümle ve 2 quiz sorusu aşağıdaki kaynaklardan alıntılarla otomatik olarak karşılaştırıldı; 9 cümle bu karşılaştırmada düzeltildi (2026-10-09).

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[Chest wall hamartoma of infancy: a clinicopathologic observation of five cases].pubmed.ncbi.nlm.nih.gov
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