Tumores y masas abdominopelvicos
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TUMORES Y MASAS ABDOMINOPELVICOS
DR JUAN MANUEL CHINO MENDOZAMR RADIOLOGIA
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MESOTELIOMA PERITONEAL
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CARCINOMATOSIS PERITONEAL - METASTASIS PERITONEAL
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DISEMINACIÓN DIRECTA
DISEMINACIÓN LINFÁTICA
DISEMINACIÓN INTRAPERITONEAL
DISEMINACIÓN HEMATÓGENA
LA CARCINOMATOSIS PERITONEAL
NÓDULOS O MASAS; PLACAS SOBRE LAS SUPERFICIES DE ESTRUCTURAS ABDOMINALES O ENGROSAMIENTOS DE LAS HOJAS PERITONEALES “OMENTAL CAKE” O ASPECTO ESTRELLADO EN LA INFILTRACIÓN DEL MESENTERIO
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LINFANGIOMA QUISTICO
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• NEOPLASIAS RETROPERITONEALES PRIMARIAS
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“Signo del pico”: cuando una masa deforma el borde del órgano adyacente produciendo una forma de pico, es probable que dicha masa se origine en ese órgano. Por el contrario, si el borde adquiere una forma roma, probablemente la masa lo esté deformando pero no se origine a partir del mismo.“Signo del órgano fantasma (invisible)”: cuando se desarrolla una gran masa a partir de un órgano pequeño, a veces éste no se detecta, por lo que esta situación se describe como el signo del órgano fantasma. Este signo tiene falsos positivos ya que hay tumores agresivos, como los sarcomas, que envuelven estructuras pequeñas como las glándulas suprarrenales, sin ser su lugar de origen.
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“Signo del órgano incrustado” : cuando un tumor comprime un órgano/estructura plástica adyacente (tracto gastrointestinal, VCI…),que no es el órgano de origen, produce una deformación del mismo en forma de media luna (signo del órgano incrustado positivo). Sin embargo, cuando es el órgano el que parece estar embebido en el tumor (signo del órgano incrustado negativo), existe una íntima superficie de contacto entre dicha estructura y el tumor, desarrollandose una reacción desmoplásica que hace esta superficie de contacto esclerótica. Cuando este signo está presente es probable que el tumor se origine a partir del órgano implicado.
“Signo de la arteria nutricia prominente” : las masas hipervasculares suelen tener un vaso nutricio prominente que se puede ver el el TC o RM y que es importante para definir su origen.
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• FIBROSIS RETROPERITONEAL
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• CUERPOS EXTRAÑOS
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• ABSCESOS
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• SIDA EN EL ABDOMEN
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90 % DE PACIENTES CON AFECTACION GASTRO INTESTINAL
68% CON AFECTACION GENITOURINARIA
50 % EN COMBINACION
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RETRO VIRIDAE
VIH SIDA
AFECCION CELULARIDAD DEL SITEMA
INMUNE
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• GRACIAS!!