摘要
目的 探讨肺部炎性肌纤维母细 胞瘤(IMT)的CT表现及病理特点。方法 回 顾性分析经手术病理证实的16例肺部IMT 患者的CT影像资料,并与临床病理对照。 结果 16例均为单发病灶,11例位于右 肺,5例位于左肺,均未见跨叶现象。CT 影像学显示形态以不规则形为主,5例边 缘光滑,11例边缘欠光整。7例密度不均 匀,9例密度均匀;增强扫描显示均有不 同程度的强化。4例可见少量积液影,4例 钙化影,3例淋巴结肿大。镜下观察可见 梭形细胞呈编织状或束状排列,间质内可 见大量浆细胞、淋巴细胞、嗜酸性细胞浸 润,免疫组化检查以波形蛋白Vimenrin、 平滑肌肌动蛋白SMA阳性为主。结论 肺部 IMT表现多样,对疾病定性诊断有一定价 值,但确诊仍需依靠临床病理和免疫组化 检查。
Objective To investigate the CT findings and pathological characteristics of pulmonary inflammatory myofibroblastoma (IMT). Methods CT imaging data of 16 patients with IMT confirmed by surgery and pathology were analyzed retrospectively and were compared with clinical pathology. Results All 16 cases were single lesions, including 11 cases located in the right lung, and 5 cases in the left lung. There was no cross lobe. CT imaging showed irregular shape, 5 cases with smooth edges and 11 cases with not finishing edges. Density of 7 cases was inhomogeneous while of 9 cases was homogeneous. Enhanced scan showed varying degrees of enhancement. There was small amount of effusion shadow in 4 cases, calcification shadow in 4 cases and lymph node enlargement in 3 cases. Microscopic observation showed that the spindle-shaped cells were woven in shape or distributed in sarciniform. There was large number of interstitial plasma cells, lymphocytes and eosinophils infiltration. Immunohistochemical examination mainly showed vimentin (Vimenrin) and positive smooth muscle actin (SMA). Conclusion Pulmonary IMT has a variety of manifestations. It is of certain value in the qualitative diagnosis of the disease, but the final diagnosis still depends on the clinical pathological and immunohistochemical examination.
【关键词】炎性肌纤维母细胞瘤;肺;体 层摄影技术;X线计算机
【中图分类号】R445.3;R734.2
【文献标识码】A
【DOI】10.3969/j.issn.1672- 5131.2017.09.021
前言
炎性肌纤维母细胞瘤(inflammatory myofibroblastic tumor, IMT)是近年来被WHO确定的一种间叶性肿瘤,可多发肺部、膀胱、肝 脏、肾等组织,以肺部较为常见[1]。IMT发病时无特异性症状,曾被诊 断为炎性假瘤、纤维黄色瘤、黏液样错构瘤等良性肿瘤,随着临床的 深入研究,发现该肿瘤可出现浸润、恶化等,属于低恶度肿瘤。肺部 IMT影像学表现与周围性肺癌的较为相似,易出现误诊[2]。因此,提高 对本病的影像学认识尤为重要。本院回顾性分析16例肺部IMT患者的CT 影响资料,并与临床病理对照,旨在提高临床对本病的认识,现报道 如下。
中国CT和MRI杂志
第15卷, 第 9 期
2017年09月
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