胸膜孤立性纤维瘤的CT表现及其病理基础

Solitary Fibrous Tumor of Pleura:CT Findings with Corresponding Pathological Basis

目的分析胸膜孤立性纤维瘤(solitary fibrous tumor of pleura,SFTP)的CT表现及其病理基础,提高对本病的认识和诊断水平。方法回顾性分析4例经手术病理证实为SFTP的CT和病理学表现。结果 4例SFTP均位于右侧胸腔,均以宽基底附着于侧胸壁,肿块呈椭圆形或类圆形,边界清楚,大小约5.0cm×3.9cm-19.0cm×15.0cm。CT平扫2例较大肿块密度不均,2例较小肿块密度均匀,增强扫描4例肿块均表现为轻度强化,2例肿瘤内部可见强化的迂曲小血管。免疫组化指标:Vimentin、CD34和Bcl-2的阳性率均为100%(4/4);S-100、SMA、CK的阴性率均为100%(4/4)。结论 CT扫描发现起源于叶间胸膜或侧胸壁的椭圆形、类圆形实性肿块,平扫密度不均匀,增强扫描不均匀强化,应想到SFTP可能。

Objective To analyze the CT findings and pathological basis of the solitary fibrous tumor of pleura （SFTP）, and improve the understanding of its imaging features. Methods CT findings were retrospectively reviewed in 4 patients with SFTP proved by operation and pathology.All the patients had undergone plain CT scan and contrast-enhanced examinations.Results All of the tumors were found as an oval or rounded and well-defined mass in the right chest, The locations of the lesions were originating from the lateral pleura in 4 patients.The lesion＇s size ranged from 5.0cm×3.9cm-19.0cm×15.0cm on CT. Unenhanced CT images showed the two more bigger lesions were heterogeneous, and the others were homogeneous.Contrast-enhanced CT images showed slight homogeneous or homogeneous enhancement in 4 cases, and there were enhanced and tortuous small vessels were observed in 2 lessions.Immunohistochemical staining showed that Vimentin positive was 100%, CD34（100%）, Bcl-2（100%）,as well as negativeS-100（100%）, SMA （100%） ,and CK（100%）.Conclusion CT findings of SFTP have the certain characteristic findings,especially an oval or rounded mass which originated from lateral pleura, with slight homogeneous or homogeneous enhancement on CT. SFTP should be included in the differential diagnosis.