胸膜孤立性纤维瘤的多层螺旋CT表现与病理特征

Multi-slice CT Findings and Pathological Manifestations of Solitary Fibrous Tumor of the Pleura

目的探讨胸膜孤立性纤维瘤(SFTP)的多层螺旋CT(MSCT)表现与病理特征。资料与方法回顾性分析经手术病理证实的11例SFTP的MSCT表现与病理特征。结果 11例均表现为胸腔单发实性肿块,5例为胸部单发巨大肿块占位病变,边缘清晰;6例为结节状肿块,肿块直径2.1～16.5cm;密度均匀(5例)或不均匀(6例),2例中央出现钙化。4例巨大肿瘤内见杂乱血管,肿瘤不均匀强化呈"地图样"。镜下肿瘤组织由梭形细胞组成,排列成编织状,局灶细胞可见核仁,间质大量胶原纤维沉积。免疫组化显示,11例患者Vim(+)、CD34(+)、S-100(-)、CK(-);其中8例CD99(+);9例Bcl-2(+)。结论 SFTP的MSCT表现有一定特征性,MSCT重建对病变的显示及诊断提供很大的帮助,病理形态学观察及免疫组化检查可以明确诊断。

Purpose To investigate the multi-slice CT（MSCT） findings and pathological characteristics of solitary fibrous tumor of the pleura（SFTP）.Materials and Methods The pathological manifestations and MSCT findings were analyzed retrospectively in 11 patients with pathology confirmed SFTP.Results Solitary tumor in thoracic cavity was found in all 11 patients,including large mass with well-defined margin in 5 patients,and single node in 6 patients.The tumor diameter was 2.1-16.5 cm,with homogeneous（n = 5） or nonhomogeneous density（n = 6）.Calcification was found in center of the tumor in 2 patients.Disorganized vessels and ＂geographic pattern＂ enhancement were found in 4 large lesions.Microscopically,SFTP was composed of spindle cells with large collagen deposition in the interstitium,arranged into weaving shape.Nucleoli could be seen clearly in some cells.Immunohistochemical staining shows Vimentin and CD34 positivein 11 cases,CD99 positive in 8 cases and Bcl-2 positive in 9 cases,as well as negative S-100 and CK in 11 cases.Conclusion MSCT of the SFTP has some characteristic features.MSCT reconstruction can provide more information to display and diagnose the tumor.