胸膜孤立性纤维性肿瘤的MSCT及病理学特征

Solitary Fibrous Tumors of Pleura:MSCT and Pathological Characteristics

目的:探讨胸膜孤立性纤维性肿瘤(SFTP)的MSCT表现及病理学特征,提高对本病的认识。方法:回顾性分析19例SFTP的MSCT表现,并与病理组织学及免疫组化对照分析。结果:19例中,CT平扫显示18例肿块边界光整,1例部分边界欠清,侵犯心包;6例密度均匀,13例密度欠均,1例可见钙化及坏死囊变;增强扫描肿块大部分中度-高度不均匀强化;11个较大肿块内可见强化血管。SFTP临床表现无特异性,可无临床症状或肿瘤压迫症状。病理学表现为肿瘤由梭形细胞与胶原以不同比例混合构成细胞密集区与疏区,间质可见血管,细胞异型性不明显。免疫组化vi mentin、CD34弥漫阳性,CK阴性。结论:SFTP是一种少见的间叶源性软组织肿瘤,临床无特异性表现;MSCT表现有一定的特征性,MSCT图像后处理有利于病变的显示和诊断;确诊须靠病理学及免疫组化检查。

Objective： To study the multi-CT （MSCT） and pathology features of solitary fibrous tumor of pleura （SFTP） ,and to enhance the knowledge of this disease entity. Methods：The MSCT features of 19 cases with SFTP were analyzed retrospectively, and correlated with pathology and Immuno-histochemistry findings. Results： On unenhanced CT, tumor presented well-defined and smooth contour in 18 cases. 1 case had partially ill-defined border and pericardium invasion;6 cases showed relatively homogeneous and 13 cases had heterogeneous attenuation. Calcification and necrosis were assessed in 1 case. On contrast enhanced CT, most part of the tumor showed moderate-marked heterogeneous enhancement, enhanced blood vessels were seen in 11 large SFTPs. The clinical findings of SFTP were non-specific, with no clinical symptoms or only with symptoms of local mass compression. The pathological features of SFTP included mixed various amount of spindle cells and collagen, the cell numbers were different in various areas, blood vessels were assessed in stroma. No ob- vious cell atypia was revealed. Positive vimentin,CD34 and negitive CK were assessed on immuno-chemistry staining. Con- clusion：SFTP is a rarely seen soft tissue tumor originated from mesenchyma with non-specific clinical features. Certain characteristic MSCT findings could be seen, MSCT post-processing techniques are very helpful in the demonstration and diagnosis of SFTP,yet final diagnosis should be based on histopathology and immunohistochemistry examinations.