炎性肌纤维母细胞瘤影像学表现与病理学分析

The imaging and pathology of inflammatory myofibroblastic tumor

目的:探讨炎性肌纤维母细胞瘤(IMT)的影像学表现及病理学特征。方法:回顾性分析手术病理证实的12例炎性肌纤维母细胞瘤患者,3例行CT平扫,10例平扫后行多期增强扫描,2例行MR检查,1例行食道钡餐检查。结果:病变位于乳突窦1例,肺部2例,纵隔2例,鼻咽1例,鼻窦1例,食道1例,胃窦1例,肝脏1例,腹膜后1例,膀胱1例,影像学表现为实性肿块8例,囊实性肿块5例,大部分病例边界清楚,增强扫描肿瘤呈均匀或不均匀中度到明显强化,发生在头颈部及腹膜后的肿瘤及1例纵隔肿瘤影像表现具有侵袭性。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,影像学表现无特异性,但能为其提供准确的解剖部位等信息,在定性诊断方面有一定价值,最后确诊有赖于组织病理学及免疫组化检查,其免疫组化染色肌源性蛋白阳性表达是诊断IMT的重要依据。

Objective：To investigate the imaging and pathology of inflammatory myofibroblastoma（IMT）.Methods：Thirteen patients of IMT proved by pathology,in which 10 patients with contrast medium enhancement,and the imaging were analyzed retrospectively.Results：The anatomic locations included mastoid antrum（n=1）,lung（n=2）,mediastinum（n=2）,pharynx（n=1）,sinus（n=1）,gastric antrum（n=1）,esophagus（n=1）,liver（n=1）,retroperitoneum（n=1）,bladder（n=2）.Imaging findings were solid masses in eight cases,cystic and solid mass in 5 cases.The majority of cases have a clear boundary.After contrast administration,moderate or marked homogeneous or heterogeneous enhancement,was found.IMT occurred in the head and neck,retroperitoneal space,and 1 case of mediastinum tumor had invasive imaging features.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.Conclusion：Imaging provides accurate anatomic location and helpful information for clinical diagnosis of IMT,yet the definite diagnosis relies on pathological and immunohistochemical study.