胸膜肺母细胞瘤的影像与病理对照研究

Comparative study among radiological and pathological findings in pleuropulmonary blastoma

目的 :探讨胸膜肺母细胞瘤(PPB)的影像学表现,并与病理学对照,提高对PPB影像特点的认识。方法:回顾性分析11例经手术病理证实为PPB的临床、病理、影像资料,并结合文献综合分析其影像特征。结果 :PPB主要起源于肺组织(10/11),向胸腔内突出生长,体积巨大。PPB分为Ⅰ型(囊性)、Ⅱ型(囊实性)和Ⅲ型(实性)3型,随分型越高,恶性度越高,侵袭性越强。在形态及侵袭性方面,影像学表现与病理分型有较好的一致性(10/11)。CT显示4例PPB有少许点状钙化,Ⅱ型和Ⅲ型实性部分均可见明显不均质强化。结论:PPB是儿童期少见的肺部胚胎性肿瘤,影像表现随病理分型的不同而各有特点,结合病灶部位、形态以及临床特征,影像检查可为临床提供可靠的诊断依据。

Objective：To study the radiological findings of pleuropulmonary blastoma（PPB）,and correlate the imaging with the pathologic findings so as to improve the imaging diagnostic abilities. Methods：The clinical pathological information and imaging findings of 11 cases with PPB were retrospectively analyzed,and combined with related literature to discuss radiological features.Results：PPB mainly originated in the lung tissue（10/11）,and grew towards thoracic cavity. The volume of the tumor was huge in general. PPB was divided into type Ⅰ（cystic）,type Ⅱ（cyst-solid） and type Ⅲ（solid）. With the increase of the grade,the tumor became more malignant and more invasive. In terms of morphology and invasiveness,imaging finding and pathological type matched greatly（10/11）. Punctate calcification was shown on CT imaging in four cases,the solid part of all type Ⅱ and type Ⅲ cases were enhanced obviously. Conclusions：Pleuropulmonary blastoma is a kind of rare lung embryonal tumor in childhood. According to different pathological types,imaging features of PPB have different characteristics. Combined with the lesion site,morphology and clinical characteristics,imaging examinations can provide a reliable diagnosis for clinician.