原发性肺滑膜肉瘤CT表现及鉴别诊断

The diagnosis and differential diagnosis of primary pulmonary synovial sarcoma

目的:探讨原发性肺滑膜肉瘤的CT影像学特点。方法:回顾性分析贵州省人民医院2015年6月—2019年8月经手术及病理证实的原发性肺滑膜肉瘤患者4例的CT影像学资料。结果:原发性肺滑膜肉瘤表现为圆形或类圆形实性块影,平均直径69 mm(范围23~130 mm),边界光滑,1例见浅分叶,无毛刺及胸膜凹陷;增强后肿瘤呈持续性不均匀强化,肿瘤越大者血供越丰富;1/4例患者合并胸腔积液,4例患者均未发生淋巴结转移。结论:原发性肺滑膜肉瘤极为罕见,常表现为肺外周较大的异质性肿瘤,常无纵隔及肺门淋巴结转移,术前容易误诊。

Objective To explore the Imaging characteristics of primary pulmonary synovial sarcoma.Methods CT imaging data of 4 patients with primary synovial sarcoma of the lung confirmed by surgery and pathology admitted to Guizhou Provincial People's Hospital from June 2015 to August 2019 were analyzed retrospectively.Results Primary pulmonary synovial sarcoma is always round,large with an average diameter of 69 mm(range 23~130 mm).3/4 patients show heterogeneous enhancement.1/4 patients had pleural effusion,and all patients has no lymph node metastasis occurred.Conclusion Primary pulmonary synovial sarcoma is extremely rare.The most common CT appearance is that of a heterogeneous large soft-tissue mass without mediastinal and hilar lymph node metastasis.