网站首页期刊介绍通知公告编 委 会投稿须知电子期刊广告合作联系我们
最新消息:
胸部孤立性纤维瘤的CT表现及病理对照分析
作者:黄敏  胡春峰  孙林林  李磊 
单位:徐州医科大学附属医院 医学影像科, 江苏 徐州 221002
关键词:胸部肿瘤 孤立性纤维瘤 计算机断层扫描 
分类号:R814.42;R816.41
出版年·卷·期(页码):2020·39·第六期(732-736)
摘要:

目的: 探讨胸部孤立性纤维瘤(SFT)的CT表现及其诊断价值。方法: 回顾性分析17例胸部SFT患者的临床及影像学资料,并与其病理结果进行对照分析。结果: 17例胸部SFT患者中,8例出现胸闷、2例胸痛、7例咳嗽;病灶最大径1.6~18.2 cm;其中12例位于右侧胸腔,4例位于左侧胸腔,1例两肺多个病灶;CT平扫显示所有病灶内出现钙化2例,坏死7例;同侧胸腔积液1例;1例病灶位于左肺上叶支气管盲端且伴有支气管闭塞;增强扫描后10例出现不均匀"地图状"强化,5例出现明显的供血血管,7例呈轻-中度均匀强化;病理结果显示17例中CD34+ 15例,B淋巴细胞瘤-2基因(bcl-2)+17例;有3例病灶为恶性,其中2例抗原ki-67+>10%,1例约5%。结论: 胸部SFT的CT表现具有一定的特征性,是可靠的诊断方法,但确诊本病依旧需要依靠病理检查结果,抗原ki-67对本病的良恶性具有提示性意义。

Objective: To explore the CT manifestation of thoracic solitary fibrous tumor(SFT).Methods: The clinical and imaging data of 17 patients with thoracic SFT were analyzed retrospectively. The histopathology results of patients were compared to analyse.Results: Among 17 patients, 8 of them appeared chest tightness, while 2 with chest pain and 7 with cough. The diameter of the lesions were among 1.6 cm to 18.2 cm. On plain CT scan, 12 lesions were in the right thorax when 4 in the left and 1 was multiple in two lung. Intralesional calcification or necrosis were seen in 2 and 7 cases respectively, pleural effusion appeared in 1 case. 1 case was located at the blind end of the left superior lobar bronchus, accompanied with bronchial obstruction. After enhancement, 10 lesions showed heterogenerous "map" enhancement, 5 demonstrated obvious feeding vessel when 7 showed homogenerous mild-moderate enhancement. The histology approved that CD34 of 15 cases were positive, bcl-2 of 17 cases appeared positive, 3 cases were diagnosed as malignant, antigen ki-67+>10% occurred in 2 cases as one about 5%.Conclusion: Thoracic SFT shows certain characteristics on CT, which can be regarded as reliable diagnosed method. However, the final diagnosis confirmed by pathology test, antigen ki-67 can be used to presume the benign and malignant of the tumor.

参考文献:

[1] 赖丙林,吕国士,石义志.MSCT增强扫描诊断胸膜孤立性纤维瘤的价值[J].实用放射学杂志,2016,32(10):1532-1534,1538.
[2] 强军,陈殿森,陈岚,等.巨大淋巴结增生症肺部CT表现[J].中国医学影像技术,2018,34(3):358-361.
[3] DE PERROT M,FISCHER S,BRUNDLER M A,et al.Solitary fibrous tumor of the pleura[J].Ann Thorac Surg,2002,74(1):285-293.
[4] AYDEMIR B,CELIK S,OKAY T,et al.Intrathoracic giant solitary fibrous tumor[J].AM J Case Rep,2013,14:91-93.
[5] 姚洪祥,张金山,白友贤,等.胸膜孤立性纤维瘤的CT表现[J].中国医学影像学杂志,2006,14(6):406-409.
[6] CHICK J F,CHAUHAN N R,MADAN R.Solitary fibrous tumors of the thorax:nomenclature,epidemiology,radiologic and pathologic findings,differential diaginoses,and management[J].AJR Am J Roentgenol,2013,200(3):W238-W248.
[7] 张颖,周全,沈兵,等.肺恶性孤立性纤维性肿瘤2例临床病理观察[J].诊断病理学杂志,2015,22(7):422-425.
[8] 巩书磊,张曙光.胸膜孤立性纤维瘤的特别分组方法[J].中国医科大学学报,2016,45(4):368-370.
[9] LOCOCO F,CESARIO A,CARDILLO G,et al.Malignant solitary fibrous tumors of the pleura:retrospective review of a multicenter series[J].J Thorac Oncol,2012,7(11):1698-1706.
[10] GRANSHAW I M,GIKAS P D,FISEHER C,et al.Clinical outcomes of extra-thoracic solitary fibrous tumors[J].Eur J Surg Oncol,2009,35(9):994-998.
[11] PARK M S,ARAUJO D M.New insights into the hemangiopericytoma/solitary fibrous tumor septrum of tumors[J].Curr Opin Oncol,2009,21(4):327-331.
[12] 刘衡,柏永华,史军丽,等.盆腔孤立性纤维瘤的螺旋CT表现[J].临床放射学杂志,2014,33(1):136-139.
[13] 李辉,陈自谦,姚丽青,等.良恶性孤立性纤维瘤的影像诊断及病理对照[J].实用放射学杂志,2012,28(4):519-522.
[14] 姚军,夏进东,俞红兵,等.胸膜孤立性纤维瘤的MSCT表现与病理对照[J].实用放射学杂志,2014,30(2):343-345.
[15] 李浩亮,杨春燕,杨东,等.恶性胸膜孤立性纤维瘤的临床CT分析[J].医学影像学杂志,2017,27(1):48-51.
[16] YOKOI T,TSUZUKI T,YATABE Y,et al.Solitary fibrous tumor:signigicance of p53 and CD34 immunoreactivity in its malignant transformation[J].Histopathology,1998,32(5):423-432.
[17] LIU Y,ISHIBASHI H,SAKO S,et al.A giant mesentery malignant solitary fibrous tumor recurring as dedifferentiated liposarcoma-a report of a very rare case and literature review[J].Gan To Kagaku Ryobo,2013,40(12):2466-2469.
[18] VIMI S,PUNNYA V A,KAVERI H,et al.An aggressive solitary fibrous tumor with evidence of malignancy:a rara case report[J].Head Neck Pathol,2008,2(3):236-241.
[19] 罗志凌.腹膜后孤立性纤维瘤的影像诊断进展[J].国际医学放射学杂志,2016,39(2):162-166.

服务与反馈:
文章下载】【发表评论】【查看评论】【加入收藏
提示:您还未登录,请登录!点此登录
您是第 729340 位访问者


 ©《现代医学》编辑部
联系电话:025-83272481;83272479
电子邮件: xdyx@pub.seu.edu.cn

苏ICP备09058541