原发性肺滑膜肉瘤的CT表现

CT Findings of Primary Pulmonary Synovial Sarcoma(5 Cases Report and Review of Literature)

目的探讨原发性肺滑膜肉瘤(PPSS)的CT征象特点。方法回顾性分析5例PPSS患者的影像和临床病理资料,结合相关文献进行分析总结。结果 2例病变表现为不规则铸型、鹿角状或指状;2例呈类圆形肿块,1例呈不规则团块状。各例边缘均未见毛刺征,2例边缘伴浅分叶或切迹。4例病灶内见灶状或片状坏死区;1例肿块型病灶内可见点状钙化。2例肿块型病灶致邻近肋骨侵蚀破坏。增强动脉期病变呈轻、中度均匀或不均匀强化,静脉期呈持续渐进性轻、中度或明显强化。2例合并同侧胸腔积液;1例伴纵隔淋巴结肿大,其余各例均未见纵隔及肺门淋巴结肿大。结论 PPSS的CT表现具有相对特异性,确诊需要依靠病理和免疫组织化学检查。

Objective To investigate the CT imaging characteristics of Primary Pulmonary Synovial Sarcoma（ PPSS）and improve the diagnostic level for it. Methods The imaging,clinical and pathology information of 5 patients with PPSS was retrospectively analyzed and summarize by combining relevant literature. Results The tumors displayed irregular casting shape,staghorn shape or fingerlike in 2 cases,quasi-circular mass in 2 cases and irregular agglomerate in 1 case. Spicule sign was not found in all cases,however there were shallow leaflet or incisure sign on the edge of the masses in 2 cases.Focal or flake necrosis was seen in 4 cases and punctiform calcification in 1 mass. Two masses caused bone destruction of adjacent rib. All of the lesions showed mild to moderate homogeneous or inhomogeneous enhancement during the arterial phase and mild,moderate or obvious continuous progressive enhancement during the venous phase. Two cases were accompanied by ipsilateral hydrothorax. No hilar and mediastinal lymph nodes swelling were seen except 1 case with mediastinal lymph nodes swelling. Conclusion CT features of PPSS are of certain relative specificity. However it is necessary for making a definite diagnosis to depend on pathology and immunohistochemistry.