胸部孤立性纤维瘤的HRCT表现及鉴别诊断

目的探讨胸部孤立性纤维瘤(SFT)的HRCT表现及鉴别诊断,提高诊断准确性。方法回顾性分析24例经病理证实的胸部SFT的临床资料及病理表现,总结其HRCT影像表现。结果24例均表现单发肿块,位于肺内和胸壁各2例,纵隔5例,胸膜15例。肿块最大径7~134 mm,8例最大径>100 mm,16例最大径<100 mm,1例出现胸腔积液,1例出现淋巴转移,6例明显强化,4例呈“地图样”强化,4例瘤内或瘤周出现增粗迂曲血管影。结论HRCT检查对胸部SFT具有一定的诊断价值,确诊依赖病理和免疫组化检查。

Objective To investigate the HRCT manifestations and differential diagnosis of isolated fibrous tumor(solitary fibrous tumor,SFT)in the chest and improve the diagnostic accuracy.Methods The clinical data and pathological manifestations of 24 cases of pathologically confirmed chest SFT were retrospectively analyzed,and their HRCT imaging manifestations were summarized.Results All 24 cases showed a single mass,located in the lung and chest wall in 2 cases each,mediastinum in 5 cases,and pleura in 15 cases.The maximum diameter of the masses ranged from 7 to 134 mm,8 cases had a maximum diameter of>100 mm,16 cases had a maximum diameter of<100 mm,1 case showed pleural effusion,1 case showed lymph node metastasis,6 cases showed significant enhancement,4 cases showed"map-like"enhancement,and 4 cases showed thickened and tortuous vascular shadow within or around the tumor.Conclusion HRCT examination has a certain diagnostic value for SFT in the chest,and the definite diagnosis depends on pathology and immunohistochemical examination.