肺原发恶性纤维组织细胞瘤CT诊断

CT diagnosis of primary lung malignant fibrous histocytoma

目的探讨肺原发恶性纤维组织细胞瘤（PLMFH）的CT诊断价值。方法回顾性分析36例经针吸活检或手术病理证实的PLMFH的CT表现,分析其影像学特点。结果36例病灶均为单发,多为周围型（34例）。病灶〈5cm8例,≥5cm28例,其中≥10cm5例,肿块形态规则呈类圆形25例,不规则伴分叶11例;密度均匀呈实性密度9例,密度不均匀26例。增强扫描12例,其中10例均有中-高度强化,2例有轻度强化。病灶侵及胸壁13例,侵及心包及肺静脉各1例,肺门、纵隔淋巴结转移6例,远处转移4例。7例行免疫组化检查均为Vim（＋）,CD68（＋）,CKpan（-）,EMA（-）,S-100（-）。结论肺原发恶性纤维组织细胞瘤的CT表现有一定的特征性,针吸活检后辅以免疫组化技术可提高术前诊断正确率。

Objective To discuss the diagnostic value of CT in primary lung malignant fibrous histocytoma （PLMFH）. Methods CT findings of primary malignant fibrous histocytoma of the lung confirmed by surgery or percutaneous needle biopsy were retrospectively analyzed. Results There was peripheral lesions in 34 cases （94.5%） and central lesions in 2 cases （5.5%）. The image findings were large solitary mass （〉5 cm, 77.8%） with regular or irregular margin. Most of the tumors were well-circumscribed （69.4%）, and were with heterogeneous attenuation （72.2%）. The signal intensity was moderate or high. It might involve the adjacent structures. Conclusion PLMFH shows some characteristics on CT. Percutaneous needle biopsy and immunohistochemical method are able to provide useful information in the diagnosis of PLMFH.