肺炎性肌纤维母细胞瘤CT影像学特征及病理结果28例分析

CT IMAGING FEATURES AND PATHOLOGICAL RESULTS OF PULMONARY INFLAMMATORY MYOFIBROBLASTIC TUMOR:AN ANALYSIS OF 28 CASES

目的对肺炎性肌纤维母细胞瘤CT影像学特征及病理结果进行分析,以提高临床上对该病的认识。方法回顾性分析28例经手术或穿刺肺活检确诊为肺炎性肌纤维母细胞瘤患者的临床资料并收集肺CT影像学特征及病理检查结果进行分析。结果28例患者病灶均为单发,其中21例位于双肺下叶。CT平扫病灶密度多不均匀(21例),边缘光滑12例,不光滑16例。增强扫描呈不均匀明显强化9例,见到平直征12例,桃尖征7例,长毛刺征11例。免疫组化结果显示,Vimentin阳性表达26例,SMA阳性表达19例,ALK阳性表达9例,CD-68阳性表达12例,CD-99阳性表达9例,CK阴性表达14例,S-100阴性表达8例,CD-34阴性表达13例。结论肺炎性肌纤维母细胞瘤影像表现对临床早期诊断具有提示作用,结合组织病理学及免疫组化检查结果对评估患者预后及术后诊治情况具有重要意义。

Objective To investigate the CT imaging features and pathological results of pulmonary inflammatory myofibroblastic tumor,and to improve the awareness of this disease in clinical practice.Methods A retrospective analysis was performed for the clinical data,CT imaging features,and pathological results of 28 patients who were diagnosed with pulmonary inflammatory myofibroblastic tumor by surgery or lung biopsy.Results All 28 patients had a solitary lesion,among whom 21 had a lesion located in the left and right lower lobes of lungs.Plain CT scan showed inhomogeneous density of the lesion in 21 patients,lesions with smooth margins in 12 patients,and lesions with unsmooth margins in 16 patients,and contrast-enhanced CT scan showed obvious heterogeneous enhancement in 9 patients,flat sign in 12 patients,peach-tip sign in 7 patients,and long spiculation sign in 11 patients.Immunohistochemistry showed positive expression of Vimentin in 26 patients,SMA in 19 patients,ALK in 9 patients,CD-68 in 12 patients,and CD-99 in 9 patients and negative expression of CK in 14 patients,S-100 in 8 patients,and CD-34 in 13 patients.Conclusion The specific imaging findings of pulmonary inflammatory myofibroblastic tumor may help with early clinical diagnosis,and a combination of histopathology and immunohistochemistry is of great significance for prognostic evaluation and postoperative diagnosis and treatment.