原发性腹膜后恶性纤维组织细胞瘤的CT诊断

CT Diagnosis of Primary Retroperitoneal Malignant Fibrous Histiocytoma

目的:提高对原发性腹膜后恶性纤维组织细胞瘤CT表现的认识。方法:回顾性分析13例经手术或CT导引下穿刺活检病理证实原发性腹膜后恶性纤维组织细胞瘤的CT表现。13例均行平扫及增强扫描。结果:CT平扫肿瘤大小11～19cm,平均15cm。肿瘤形态不规则伴明显分叶,坏死部分占肿瘤体积的大部分,病灶呈浸润性生长。6例伴瘤内出血,4例伴瘤内钙化。增强扫描肿瘤实质部分不均匀性中度强化,6例可见轨道征。结论:原发性腹膜后恶性纤维组织细胞瘤的CT表现主要为肿瘤较大并向周围浸润生长,肿瘤内部坏死显著,瘤内出血常见。轨道征对诊断该病具有一定的价值。

Objective：To achieve better understanding of CT manifestations of primary retroperitoneal malignant fibrous histioeytoma. Methods：CT manifestations of 13 cases of primary retroperitoneal fibrous histioeytoma proved by pathology were studied retrospectively. Both plain and enhanced CT scanning was performed in all cases. Results： CT appearances were as follows：the size of the scanned masses ranged from 11 to 19cm （15cm in average）. The masses were irregular in shape and lobulated in configuration,where necrosis occupied the main portion of the mass volume. The lesion displayed invasive growth. Tumor hemorrhage was found in 6 cases and intratumoral calcification occurred in 4 cases. Under enhanced scan, the tumor parenchyma showed heterogeneous moderate contrast enhancement,and 6 cases demonstrated railway-track signs. Conclusion：CT manifestations of primary retroperitoneal malignant fibrous histioeytoma are mainly as follows： the masses are relatively big,and tend to show invasive growth, noticeable display of necrosis and tumor hemorrhage is often found. Railway-track signs in the masses have referential value in the diagnosis of this disease.