炎性肌纤维母细胞瘤的多层螺旋CT表现

Multi-slice spiral CT imaging of inflammatory myofibroblastoma

目的探讨炎性肌纤维母细胞瘤(IMT)的多层螺旋CT表现,以提高对该病影像表现的认识。方法回顾性分析2005年3月—2008年2月经手术病理证实的IMT共18例,病变位于肺部6例,肝脏1例,脾脏2例,胆总管1例,腹膜后1例,盆腔1例,上颌窦2例,浅表软组织4例。4例患者行CT平扫,14例平扫后行单期或多期增强扫描。结果肺内病变2例为中央型,CT表现为边界清楚的实性肿物;4例为周围型,其中3例表现为边界不清、形态不规则的肿物,1例表现为边界光整的小结节。肺外病变CT表现为不同部位的实性肿物或结节。增强扫描肿瘤呈均匀或不均匀中度到明显强化。病理示瘤组织由梭形纤维细胞及炎细胞组成,免疫组化染色肌源性蛋白阳性表达。结论IMT是一种少见的肿瘤,多层螺旋CT检查能为其提供准确的解剖部位等信息,在定性诊断方面尤其对肺内病变有一定价值,最后确诊有赖于组织病理学及免疫组化检查。

Objective To investigate the multi-slice spiral CT imaging of inflammatory myofibroblastoma（IMT）.Methods Eighteen patients of IMT proved by pathology from March 2005 to February 2008 were examined with multi-slice spiral CT before surgery,in which 14 patients with contrast medium enhancement,and the CT imaging were analyzed retrospectively.The anatomic locations included lung（n=6）,liver（n=1）,spleen（n=2）,commonbile duck（n=1）,retroperitoneum（n=1）,pelvic cavity（n=1）,maxillary sinus（n=2）and superficial soft tissue（n=4）.Results In terms of lung lesions,there were 2 central lesions presented as solid masses with well-defined margin;4 peripheral lesions,3 of which lesions presented as irregular solid masses with ill-defined margin and 1 lesion as an round nodule with well-defined margin.The lesions out of the lung presented as solid masses or nodules on CT in diverse sites.After contrast administration,moderate or marked enhancement,homogeneously or heterogeneously,were found.The tumors were mainly composed of spindle shaped fibrous cells and inflammatory cells on pathology,and positive staining for muscle deriving proteins was observed immunohistochemically.Conclution MSCT provides accurate anatomic location and helpful information for the clinical diagnosis of IMT,yet the definite diagnosis relies on pathological and immunohistochemical study.