胸膜原发性肿瘤的影像学诊断(附26例分析)

Imaging diagnosis of primary tumor of pleura (with report of 26 cases)

目的 :分析胸膜原发性肿瘤的影像学特点 ,探讨胸膜原发性肿瘤与肺内肿块鉴别诊断的要点。方法 :回顾性分析 2 6例经手术病理证实的原发性胸膜肿瘤的影像学资料。其中 ,胸膜间皮瘤 2 0例、胸膜神经鞘瘤 4例、神经纤维瘤 1例及胸膜纤维脂肪瘤 1例。结果 :胸膜间皮瘤影像学表现为 3种类型 :单发胸膜肿块型、多发胸膜肿块及结节状胸膜增厚型、胸膜积液为主型。单发肿块良、恶性均有。多发性肿块或结节状胸膜增厚伴胸腔积液时 ,多见于恶性弥漫型胸膜间皮瘤。胸膜神经鞘瘤、神经纤维瘤及胸膜纤维脂肪瘤均具有良性肿瘤的特征。结论 :胸膜原发性肿瘤虽无特征性影像学表现 ,仔细综合分析各种影像学征象特点 。

Objective:To analyze imaging features of primary tumors of pleura and to explore differential diagnosis of primary tumors of pleura and pulmonary masses.Methods:Imaging findings in 26 cases with surgically and pathologically proved primary tumors of pleura were reviewed retrospectively,including pleural mensothelioma 20 cases,pleural neurilemmoma 4 cases,neurinoma 1 cases,pleural fibrolipoma 1 case.Results:Imaging findings of pleural mesothelioma were classified into three types:single mass,multiple masses and nodular pleural thickening with pleural effusion.The solitary mass could be benign or malignant.Multiple masses or nodular pleural thicken ing with pleural effusion were most common imaging findings of malignant diffuse pleural mensothelioma.Pleural neurilemmoma,neurinoma and pleural fibrolipoma usually had the characteristics of benign neoplasm.Conclusion:There is no pathognomonic imaging features for primary tumors of pleura.However,it is very important to improve the diagnosis of this disease when its imaging features are carefully and comprehensively analyzed.