肺及纵隔原发性上皮样血管内皮瘤的CT表现与病理对照分析

CT diagnosis of primary epithelioid hemangioendothelioma of the pulmonary and mediastinum and comparison to pathology

目的探讨肺及纵隔原发性上皮样血管内皮瘤的CT表现特点,提高其影像诊断水平。方法选取9例经病理证实的肺及纵隔原发性上皮样血管内皮瘤的临床资料、病理结果及CT表现。结果9例肺及纵隔原发性上皮样血管内皮瘤中,2例位于纵隔者均为单发团状病灶,7例位于肺组织者,2例为单发块状病灶,5例为多发结节病灶。CT平扫2例纵隔内均见软组织肿块,1例边界清晰,瘤内可见斑块状钙化灶,另1例呈浸润生长,与周围组织分界不清;7例内见团块状或多发结节状,部分瘤体内可见斑点状钙化灶。增强扫描团块状病灶强化相对明显,结节状病灶强化程度较弱。结论肺及纵隔原发性上皮样血管内皮瘤较为罕见,临床症状与影像学表现均无特征性,仅能通过病理学检查结合免疫组化确诊此病。

Objective To explore imaging diagnosis of primary epithelioid hemangioendothelioma of the pulmonary and mediastinumand,and to improve diagnostic capacity.Methods A retrospective analysis was made on clinical data,pathological results and imaging findings of 9 cases with pathologically approved primary epithelioid hemangioendothelioma of the pulmonary and mediastinumand.Results Among the 9 cases of primary epithelioid hemangioendothelioma of the pulmonary and mediastinumand,2 cases located in the mediastinum had single mass lesions,7 cases located in the pulmonary,2 cases had single mass lesion,and 5 cases had multiples nodules.CT plain scan showed soft tissue mass in 2 cases located in the mediastinum,1 case had clear boundary and patchy calcification,the other one showed infiltration growth,and the boundary of tumor was not clear with surrounding tissue;7 cases in the pulmonary showed masses or multiple,and some of these tumors had speckle calcification.In the enhancement scan,mass lesions had relatively obvious enhancement,while,the enhancement of nodular lesions was relatively weak.Conclusion Primary epithelioid hemangioendothelioma of the pulmonary and mediastinumand is rare,and its clinical symptoms and imaging finds are not characteristic.It can only be diagnosed by pathological examination and immunohistochemistry.