胸部孤立性纤维瘤的MSCT表现并文献复习

Solitary Fibrous Tumors of The Pleura: The MSCT Imaging Features and Literatures Review

目的:探讨胸部孤立性纤维瘤(SFTP)影像学表现及鉴别诊断。材料与方法 :回顾性分析经术后病理确诊的9例胸部孤立性纤维瘤的影像学表现,并与病理学结果进行对照。结果:病灶位于右侧胸腔3例,左侧胸腔6例,其中左侧1例多发;6例呈椭圆或类圆形,3例呈不规则形;4例肿瘤密度较均匀,5例肿瘤密度不均,4例病灶伴有钙化;7例增强检查中1例肿瘤双期均无明显强化,3例肿瘤呈轻度强化,3例肿瘤呈中-重度渐进性不均匀强化,2例肿瘤内及瘤周见多发迂曲血管影,1例左侧肿瘤显示胃左动脉参与肿瘤供血;肿瘤均与胸膜呈宽基底相连,4例肿瘤与胸膜呈锐角,5例呈钝角;9例均无纵隔及肺门淋巴结肿大;2例伴有胸水。7例免疫组织化学结果 :CD34表达阳性6例,Bcl-2表达阳性5例,S100表达阴性7例,vimentin表达阳性7例,CD99表达阳性7例。结论:胸部孤立性纤维瘤影像学表现有一定的特征性,MSCT可以很好地显示肿瘤大小及与周围组织结构的关系,确诊有赖于病理学和免疫组织化学检查。

Objective： To investigate the imaging manifestations and differential diagnosis of solitary fibrous tumor of the pleura（SFTP）. Materials and methods： Retrospective analysis of the 9 cases of postoperative solitary fibrous tumor of the pleura pathology imaging findings and pathological resuhs were compared. Results： The lesions were located in right tho- racic cavity in 3 cases, 6 cases of left chest. Which left 1 cases multiple ; 6 cases were oval or round, 3 cases were irregular ; 4 cases of tumors with homogeneous density, 5 cases of uneven density, 4 cases of calcification in 7 cases ; 1 cases of tumor in contrast -enhanced dual phase showed no enhancement, 3 cases showed mild reinforcement 3 cases showed. In severe pro- gressive heterogeneous enhancement, 2 cases of tumor and peritumoral multiple circuitous vessels, 1 cases of left tumor showed the left gastric artery is involved in tumor blood supply; tumors are connected to the pleura with a wide base, the tumors had an acute angle to the pleura in 4 eases, obtuse angle was found in 5 cases ; 9 cases were not enlarged mediastinal and pulmo- nary hilar lymph nodes ; 2 cases with pleura1 effusion were. 7 immunohistochemical results ： CD34 expression was positive in 6 cases, 5 were Bcl - 2 positive and S100 negative expression in 7 cases, 7 were vimentin positive and CD99 positive expression in 7 cases. Conclusion ： solitary fibrous tumor imaging table Some of the existing features, MSCT can well display the size of the tumor and the relationship with surrounding tissue, However, making a definitive diagnosis still depends on pathology and immunohistochemistry.