肺硬化性血管瘤的MSCT特征与病理分析

MSCT features and pathological analysis of Pulmonary Sclerosing Hemangioma

目的探讨肺硬化性血管瘤MSCT特征表现及病理学特征,旨在提高对此病的诊断水平。方法收集我院2009年1月-2014年6月经手术及病理证实肺硬化性血管瘤共18例。回顾性分析患者的临床表现、病灶MSCT图像及病理学特征。结果 117例单发,1例多发(2个病灶),共19个病灶,其中7个病灶发生于左肺下叶,6个病灶发生于右肺中叶,两者占所有病灶的68.4%。14个(约73.7%)病灶为周围型,5个病灶为中央型。2所有病灶界限清楚,2例病灶可见浅分叶,其余病灶均呈类圆形;2例病灶内见斑点钙化。3所有病灶均呈不均匀性持续性强化,12例病灶边缘见"血管贴边征",3例病灶周围见"晕征",2病灶周围见肺气肿征。4病理上病灶组织内均包含血管瘤样区、乳头区、实变区和硬化区,且按不同比例混合存在。免疫组化显示:TTF(+)。结论肺硬化性血管瘤MSCT表现较具特征性,MSCT有助于术前该疾病的正确诊断。

Objective To discuss the Muhislice CT （MSCT） findings and pathologic characteristics of pulmonary sclerosing hemanagioma （PSH）, in order to improve the diagnosis ability of PSH. Methods 18 PSH cases confirmed by surgery and histopathology were enrolled from January, 2009 years to June, 2014 years. Retrospective analysis of the clinical manifestation, MSCT features and pathologic characteristics of PSH were performed. Results （1）17 cases had isolated mass, and 1 case had 2 lesions, a total of 19 lesions. Of these lesions, 7 lesions arised from inferior lobe of left lung and 6 lesions arised from middle lobe of right lung, both of these lesions occupied for 68.4%. In addition, 14 （73.7%） and 9 lesions were located in peripheral and central lung, respectively. （2）Of all cases were well-defined. The majority of lesions presented round or oval, except for 2 lesions showed slight lobulation. Spot calcification was found in 2 lesions. （3）Non-uniformity and continuous enhancement was loud in all lesions. Blood vessel marginating sign was found in 12 cases（63.2%）, the halo sign was found in 3 cases and the air meniscus sign was found in 2 cases. （4）PSH was composed of hemorrhagic area, papillary area, solid area, sclerotic area with different proportion. Immunohistochemistry study showed TTF（＋）. Conclusion The imaging features of PSH is characteristic, MSCT is helpful to make accurate diagnosis before operation.