原发性腹膜后恶性纤维组织细胞瘤的CT征象分析

CT features of primary malignant retroperitoneal fibrous histiocytoma

目的观察原发性腹膜后恶性纤维组织细胞瘤(MFH)的CT表现。方法回顾性分析25例经手术病理证实的原发性腹膜后MFH患者的临床资料及CT表现。结果17例患者病灶单发,8例多发,共37个病灶,平均直径12.85cm;32个呈浅分叶状,5个类圆形;28个边界较清,9个边界不清;7个病灶平扫表现为均匀等密度,30个密度不均,其内可见坏死、囊变、出血及钙化。增强扫描37个病灶动脉期肿瘤实质呈轻度强化,静脉期呈中度强化。25例患者均接受免疫组化检查:Vimentin、CD68、AACT、S-100、CKpan和EMA的阳性率分别为94.74%、90.48%、88.24%、0、0和15.00%。结论原发性腹膜后MFH的CT表现具有一定的特征性,有助于该病的诊断,确诊需依靠病理细胞学及免疫组化检查。

Objective To observe CT characteristics of primary retroperitoneal malignant fibrous histiocytoma （MFH）. Methods CT images and clinical data of 25 patients with primary retroperitoneal MFH proved pathologically were reviewed and analyzed retrospectively. Results A total of 37 lesions were identified in 25 patients, in which 17 had single lesion and 8 had multiple lesions, with mean diameter of the tumor of 12.85 cm, including 32 light lobulated and 5 round-shaped lesions. Among all 37 lesions, 28 were well defined and the others had unclear border, while 7 masses were homogenous in density and the other 30 were inhomogenous with necrosis, cysts, bleeding or calcification. All lesions enhanced in various degrees with slight enhancement in arterial phase and moderate enhancement in venous phase. All the patients underwent immunohistocbemistry examination, and the positive rate of Vimentin, CD68, AACT, S-100, CKpan and EMA were 94.74%, 90.48%, 88.24%, 0, 0 and 15.00%, respectively. Conclusion Primary retroperitoneal MFH have some specific CT manifestations that being helpful to the diagnosis, but final diagnosis depends on the cytopathology and immunohistoehemistry.