原发性肝恶性纤维组织细胞瘤的螺旋CT表现

Characteristics of spiral computed tomography imaging of primary hepatic malignant fibrous histiocytoma

恶性纤维组织细胞瘤是成年人常见的原发性软组织肉瘤。常发生于肢体近端的深部、腹膜后和躯干，而原发于肝脏者极为罕见，国内文献报道不足60例，且多以个案报道为主。本研究回顾性分析1999年10月至2008年5月烟台市肿瘤医院、烟台毓璜顶医院和温州医学院附属第一医院收治的5例原发性肝恶性纤维组织细胞瘤患者的临床资料，总结该病的螺旋CT表现特征。

Primary hepatic malignant fibrous histioeytoma （PHMFH） remains extremely rare with less than 60 cases reported in literature. From October 1999 to May 2008, 5 patients with PHMFH had been admitted to Yantai Cancer Hospital, Yantai Yuhuangding Hospital and the First Affiliated Hospital of Wenzhou Medical College, and the results of spiral CT were analyzed. Six tun）ors were detected, and the maximum diameter of the tumors was more than 8.5 cm. CT plain scanning revealed that all tumors were bypodense, 4 patients with tumor necrosis and cystic degeneration, and the tumor in 1 patient was with homogen density. Enhanced CT scanning showed marked enhancement of the solid component of tumor in 4 patients, slight enhancement in 1 patient, and a ＂fast in and fast out＂ sign in 5 patients. Hepatic bile ducts and portal vein were not involved. One patient was with portal lymph node metastasis and 1 with inferior vena cava involvement. The characteristics of spiral CT imaging of PHMFH include tumor necro- sis, cystis and invasion, as well as ＂fast in and fast out＂ sign, which could help to diagnose, although the uhimate diagnosis depends on histopathological examination.