论著-头颈部
胸膜孤立性纤维瘤 的CT表现及其病理 基础
作者:余 洪1 张 文1 刘 衡1 柏永华2 骆科进1 张体江1 李邦国1
所属单位:1.遵义医学院附属医院影像科 (贵州省医学影像中心) 2.遵义医学院附属医院病理科 (贵州 遵义 563003)
PDF摘要
目的 分析胸膜孤立性纤维瘤 (solitary fibrous tumor of pleura, SFTP)的CT表现及其病理基础,提高对本 病的认识和诊断水平。方法 回顾性分析4 例经手术病理证实为SFTP的CT和病理学表 现。结果 4例SFTP均位于右侧胸腔,均以 宽基底附着于侧胸壁,肿块呈椭圆形或类 圆形,边界清楚,大小约5.0cm×3.9cm19.0cm×15.0cm。CT平扫2例较大肿块密 度不均,2例较小肿块密度均匀,增强扫 描4例肿块均表现为轻度强化,2例肿瘤内 部可见强化的迂曲小血管。免疫组化指 标:Vimentin、CD34和Bcl-2的阳性率均 为100%(4/4);S-100、SMA、CK的阴性率 均为100%(4/4)。结论 CT扫描发现起源于 叶间胸膜或侧胸壁的椭圆形、类圆形实性 肿块,平扫密度不均匀,增强扫描不均匀 强化,应想到SFTP可能。
Objective To analyze the CT findings and pathological basis of the solitary fibrous tumor of pleura (SFTP), and improve the understanding of its imaging features. Methods CT findings were retrospectively reviewed in 4 patients with SFTP proved by operation and pathology.All the patients had undergone plain CT scan and contrastenhanced examinations. Results All of the tumors were found as an oval or rounded and well-defined mass in the right chest, The locations of the lesions were originating from the lateral pleura in 4 patients.The lesion's size ranged from 5.0cm×3.9cm19.0cm×15.0cm on CT. Unenhanced CT images showed the two more bigger lesions were heterogeneous, and the others were homogeneous.Contrast-enhanced CT images showed slight homogeneous or homogeneous enhancement in 4 cases, and there were enhanced and tortuous small vessels were observed in 2 lessions.Immunohistochemical staining showed that Vimentin positive was 100%, CD34(100%), Bcl-2(100%),as well as negativeS-100(100%), SMA (100%) ,and CK(100%). Conclusion CT findings of SFTP have the certain characteristic findings,especially an oval or rounded mass which originated from lateral pleura, with slight homogeneous or homogeneous enhancement on CT. SFTP should be included in the differential diagnosis.
【关键词】孤立性纤维瘤;胸膜;计算机 体层摄影;病理基础;外科
【中图分类号】R322.3+6
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2016.10.018
前言
胸膜孤立性纤维瘤(solitary fibrous tumor of pleura,SFTP) 首次报道于上世纪30年代,属少见的梭形细胞肿瘤,起源于间叶组 织。当前,仍然存在对该肿瘤认识不够并容易误诊的现象,基于此, 作者收集4例确诊为SFTP患者的相关资料,将重心放在分析其CT图像和 病理表现上,希望能帮助医生提高对该肿瘤的影像诊断水平。
中国CT和MRI杂志
第14卷, 第 10 期
2016年10月
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