胸膜少见原发肿瘤的CT诊断

CT diagnosis of rare primary tumor of pleura

目的:探讨胸膜少见原发肿瘤的CT特征,以提高诊断水平。方法:回顾性分析15例经病理证实的胸膜少见原发肿瘤患者的CT及临床资料。结果:15例均为单发,其中右侧8例,左侧7例。7例为孤立性纤维性肿瘤,其中5例呈丘状或半圆形,2例呈不规则分叶状;增强扫描3例呈轻中度均匀强化,4例呈中度明显强化;6例见胸膜尾征,2例见胸腔少量积液。4例神经鞘瘤,其中1例呈梭形,1例呈球形,2例呈半圆形;增强扫描1例轻度均匀强化,3例中度不均匀强化;3例见胸膜尾征。2例炎性肌纤维母细胞瘤,均呈类圆形;增强扫描1例呈中度延迟强化,1例边缘呈结节状明显强化;1例见胸膜尾征。1例纤维脂肪瘤,呈脂肪及纤维混杂密度梭形肿块,边界清晰,增强扫描纤维成分呈轻度延迟强化。1例滑膜肉瘤,呈巨大不规则囊实性肿块、等及较低混杂密度,增强扫描呈中度延迟强化,同时见胸腔积液、肺不张、肋骨破坏及肝脏转移。结论:胸膜少见原发肿瘤的CT表现各具特点,CT对其诊断具有重要价值。

Objective:To investigate the CT features of rare primary tumors of pleura and to improve the diagnostic level.Methods:The CT and clinical data of 15 cases of rare primary pleural tumors confirmed by pathology were analyzed retrospectively.Results:All 15 cases had a single lesion,8 lesions located in the right thoracic cavity and 7 in the left side.In 7 cases of solitary fibrous tumor,5 lesions were mound shaped or semicircular,2 lesions were irregular lobulated.3 lesions showed mild to moderate homogeneous enhancement,4 lesions showed moderate to obvious enhancement.The‘pleural tail’sign could be observed in 6 cases,and a small amount of pleural effusion could be observed in 2 cases.Among 4 cases of schwannoma,1 lesion was fusiform,1 was spherical and 2 lesions were semicircular.1 lesion showed mild homogeneous enhancement and 3 lesions showed moderate heterogeneous enhancement.The‘pleural tail’sign could be observed in 3 cases.2 cases of inflammatory myofibroblastic tumor presented as round mass,1 lesion showed moderate delayed enhancement and 1 lesion showed nodular obvious enhancement of the marginal area.The‘pleural tail’sign could be observed in 1 case.1 case of fibrolipoma showed mixed density fusiform mass of fat and fiber,with clear boundary and mild delayed enhancement of fiber components.1 case of synovial sarcoma showed huge irregular cystic solid mass,with mild delayed enhancement,pleural effusion,atelectasis,rib destruction and liver metastasis could be observed meanwhile.Conclusion:The CT characteristics of different rare primary pleura tumors are different,and CT shows important value in the diagnosis.