胸部孤立性纤维瘤的CT表现及病理对照分析

CT features and pathology of thoracic solitary fibrous tumor

目的:探讨胸部孤立性纤维瘤(SFT)的CT表现及其诊断价值。方法:回顾性分析17例胸部SFT患者的临床及影像学资料,并与其病理结果进行对照分析。结果:17例胸部SFT患者中,8例出现胸闷、2例胸痛、7例咳嗽;病灶最大径1.6~18.2 cm;其中12例位于右侧胸腔,4例位于左侧胸腔,1例两肺多个病灶;CT平扫显示所有病灶内出现钙化2例,坏死7例;同侧胸腔积液1例;1例病灶位于左肺上叶支气管盲端且伴有支气管闭塞;增强扫描后10例出现不均匀"地图状"强化,5例出现明显的供血血管,7例呈轻-中度均匀强化;病理结果显示17例中CD34^+15例,B淋巴细胞瘤-2基因(bcl-2)^+17例;有3例病灶为恶性,其中2例抗原ki-67^+>10%,1例约5%。结论:胸部SFT的CT表现具有一定的特征性,是可靠的诊断方法,但确诊本病依旧需要依靠病理检查结果,抗原ki-67对本病的良恶性具有提示性意义。

Objective:To explore the CT manifestation of thoracic solitary fibrous tumor(SFT).Methods:The clinical and imaging data of 17 patients with thoracic SFT were analyzed retrospectively.The histopathology results of patients were compared to analyse.Results:Among 17 patients,8 of them appeared chest tightness,while 2 with chest pain and 7 with cough.The diameter of the lesions were among 1.6 cm to 18.2 cm.On plain CT scan,12 lesions were in the right thorax when 4 in the left and 1 was multiple in two lung.Intralesional calcification or necrosis were seen in 2 and 7 cases respectively,pleural effusion appeared in 1 case.1 case was located at the blind end of the left superior lobar bronchus,accompanied with bronchial obstruction.After enhancement,10 lesions showed heterogenerous"map"enhancement,5 demonstrated obvious feeding vessel when 7 showed homogenerous mild-moderate enhancement.The histology approved that CD34 of 15 cases were positive,bcl-2 of 17 cases appeared positive,3 cases were diagnosed as malignant,antigen ki-67^+>10%occurred in 2 cases as one about 5%.Conclusion:Thoracic SFT shows certain characteristics on CT,which can be regarded as reliable diagnosed method.However,the final diagnosis confirmed by pathology test,antigen ki-67 can be used to presume the benign and malignant of the tumor.