肺硬化性血管瘤的病理组织学与影像表现  

Histopathological and imaging findings of pulmonary sclerosing hemangioma

作　　者：蔡庆国[1] 

机构地区：[1]山东省菏泽市立医院放射科,山东菏泽274031

出　　处：《实用医学影像杂志》2005年第3期148-149,157,共3页Journal of Practical Medical Imaging

摘　　要：目的分析肺硬化性血管瘤(PSH)的病理组织学与影像表现。方法本文回顾性研究10例经手术病理证实的PSH,其中,女性8例,男性2例,年龄18岁～70岁(平均43岁)。6例摄有胸部X线平片,4例经CT平扫与增强扫描。所有病例的影像表现均与术后病理对照。影像表现是按肿瘤形状、大小、密度、边缘、以及有无分叶征及毛刺征记录的。个别PSH的主要成分是通过显微镜检查记录的。结果在X线平片上,PSH表现为孤立性类圆形结节或肿块影,大小约2.0cm～4.5cm,密度均匀,边缘清楚,无明显分叶及毛刺征。在CT像上,PSH病灶呈结节或肿块状,伴有钙化或低密度囊变区,CT值25HU～39HU。增强扫描后,病灶明显强化。CT与病理的关系是病变高密度与低密底,分别对应于其血管瘤成分与囊变区。结论CT增强扫描有助于PSH的定性诊断。Objective To analyze the imaging findings of pulmonary s clerosing hemangioma(PSH)and to compare with the histopathology. Methods Ten pat hologically proven sclerosing hemangiomas were included in this retrospective re view .Patients consisted of eight women and two men aged 18- 70 years(mean,43 y ears).Six patients underwent X- ray plain film examinations of the chest and fo ur patients underwent CT scans without and with contrast medium.Imaging findings in all patients were compared with postoperative pathology. Imaging finding wer e recorded according to tumoral shape ,size,density,margin ,and presence or abse nce of lobulated and spiculated signs.The predominant composition of an individu al sclerosing hemangioma was documented by means of microscopy.Results On X- ra y chest films,PSH presented as solitary round nodular or mass shadows,2.0— 4.5 cm in size,homogeneous density and clear margin without lobulated and spiculated signs.On CT images,PSHs were nodular or mass form associated with intratumoral calcification or cystic changes with low density ,CT value was 25— 39 HU.Follo wing enhanced scans,the lesions of PSH were significantly enhanced .On CT- path ology correlation ,the higher and lower attenuation areas corresponded with angi omatous and cystic areas,respectively.Conclusion CT enhanced scans are helpful t o make the qualitative diagnosis of PSH.

关 键 词：肺硬化性血管瘤 X线平片 CT增强扫描 病理 

分 类 号：R734.2[医药卫生—肿瘤]