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孤立性纤维瘤的影 像诊断分析

作者:彭 实

所属单位:中南大学湘雅医学院附属肿瘤医院 放射科 (湖南 长沙 410205)

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摘要

目的 总结不同部位起源的孤立 性纤维瘤的影像特点,提高对该疾病的影 像学认识。方法 回顾性分析18例(17例CT 平扫加增强、1例MRI平扫加增强)全身不 同部位起源并经手术病理及免疫组化证实 为孤立性纤维瘤患者的资料,分析上述CT 及MRI图像及肿块的影像表现。结果 18例 患者中,5例起源于胸膜,2例起源于腹膜 后,其余起源于脑实质、腮腺、咽旁间 隙、颈肩部肌间隙、肺、肝、前纵膈、空 肠、肾、盆腔、子宫圆韧带均1例;肿块 均单发,呈边界清分叶状的实性肿块,且 不均匀强化,最大径线为13cm,除1例恶 变伴双肺多发转移外,其余均为良性。结 论 孤立性纤维瘤可发生于胸膜及其以外 的多个部位或器官,巨大边界清楚呈分叶 状的不均匀密度/信号肿块,且明显不均 匀强化时,应注意孤立性纤维瘤的可能。

Objective To summarize and analyze the imaging findings of solitary fibrous tumor in different anatomic locations and further to improve the imaging understanding for this disease. Methods A total of 18 cases (17 underwent enhanced and non-enhanced CT scan,1 with enhanced and non-enhanced MR scan) with solitary fibrous tumor confirmed by pathology and immunohistochemistry technique were retrospectively analyzed ,which included the clinical material and imaging findings. Those tumors were originated from different anatomic locations. Results 5 out of 18 solitary tumors originated from pleura,2 from kidney, the remaining 11 were originated from brain, parotid, parapharyngeal space, intermuscular space in neck and shoulder, lung, liver, anterior mediastinum, jejunum, retroperitoneal space, pelvis, round ligament of uterus respectively, which manifest as well-defined lobular solid mass with obvious heterogeneous enhancement. In those tumors, the largest maximum diameter was 13cm.All tumor were confirmed to be benign except one was malignant combined with multiple lung metastasis. Conclusion Solitary fibrous tumor can occur in different anatomic locations besides the pleura. When a tumor presenting as large lobular well-defined solitary tumor with heterogeneous attenuation/intensity especially show obvious enhancement, solitary fibrous tumor should be considered.

【关键词】孤立性纤维瘤;体层摄影术; X线计算机;磁共振成像

【中图分类号】R734;R814.42

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2016.08.006

前言

孤立性纤维瘤(solitary fibrous tumor, SFT)是一种成纤维细胞 起源的间叶源性肿瘤,最初于1931年首次报道发生于胸膜[1]。文献已 报道其可发生在全身其他部位,但均为个案报道,其影像学表现缺乏特 异性,因此术前影像学误诊率较高,本文回顾分析18例全身多个不同 部位起源的孤立性纤维瘤的临床及影像资料,旨在提高对该疾病的影 像学认识,以减少术前的误诊率。