原发性肺肉瘤的影像学表现

The Imagimg Features of Primary Pulmonary Sarcoma

目的探讨原发性肺肉瘤的影像学表现。资料与方法回顾性分析7例经手术病理证实的原发性肺肉瘤患者的胸片及CT资料。7例中,滑膜肉瘤4例,血管肉瘤1例,平滑肌肉瘤1例,黏液型脂肪肉瘤1例。周围型肺肉瘤6例,中央型肺肉瘤1例。结果平片上病灶直径平均为8.1 cm,无钙化、毛刺,未见空洞。CT示浅分叶,未见毛刺,2例可见假包膜,2例可见小范围液化坏死区,无钙化。平扫时平均CT值为45.3 HU,增强后可见轻至中度强化,绝对增强均值为22.6 HU,4例邻近组织受累,1例肋骨破坏,1例血管肉瘤有肾上腺、肝脏、头颅多发转移。均未见肺门及纵隔淋巴结转移。结论原发性肺肉瘤影像学特征性表现为肿块多数位于肺外周,直径大,肺门、纵隔转移少,邻近组织受侵犯多,浅分叶,无毛刺、钙化,坏死液化范围少,增强后轻至中度强化。

Objective To explore the imaging features of primary pulmonary sarcoma.Materials and Meth-ods Chest X-ray and CT images of 7 cases with primary pulmonary sarcoma diagnosed by pathology were reviewed retrospectively.Among them,there were 4 synovial sarcomas,1 angiosarcoma,1 leiomyosarcoma,1 blenn-liposarcoma,and including 6 cases of peripheral pulmonary sarcoma,1 case of central-type pulmonary sarcoma.Results Diameter of Lesions on plain film average was average 8.1 cm without calcification,spur and empty cavity.On CT films,light sublobe without spur sign was seen,2 cases had pseudo-capsule and 2 cases had small amplitude colliquation.The average of CT attenuation of the tumor was 45.3 HU,all cases had mild-moderate enhancement,the average enhancement was 22.6HU.4 cases had local tissue encroachment,1 case had rib invasion,the angiosarcoma metastasized to adrenal,live and brain,all cases did not metastasize to lymph node of the lung hilum and mediastinum.Conclusion The imaging features of primary pulmonary sarcoma are：tumors were frequently located at peripheral part of the lung,the size is big.The tumor tends to invade the local pleural wall but rarely metastasize to the lymph node of the mediastinumor hilar,and have light sublobe without spicule sign,calcification and less small amplitude colliquation,mild enhancement is common seen.