胸膜孤立性纤维瘤的形态学特征分析  

Solitary fibrous tumor of the pluera: study of the maging findings and the pathological features

作　　者：周海榆[1,2] 陈刚[1,2] 罗东兰[3,4] 王广谊[3,5] 胡伟贤[1,2] 肖朴[1,2] 唐继鸣[1,2] 贲晓松[1,2] 谢亮[1,2] 

机构地区：[1]广东省医学科学院广东省人民医院 [2]南方医科大学附属华南医院肿瘤中心胸外科,广东广州510080 [3]南方医科大学附属华南医院 [4]广东省人民医院病理科,广州510080 [5]广东省人民医院放射科,广州510080

出　　处：《解剖学研究》2011年第3期215-218,F0003,共5页Anatomy Research

基　　金：广东省医学科研基金(B2010004)

摘　　要：目的探讨胸膜孤立性纤维瘤(SFTP)患者的临床影像学表现及病理特征。方法采用2004年1月至2010年12月在我院就诊的30例SFTP患者的临床资料,总结SFTP的临床影像学表现及主要的病理特征。结果 30例SFTP患者平均年龄53岁(28～77岁),影像学表现以胸腔及纵膈内肿块为主要表现(63.3%,19/30),其次为胸膜(壁)结节(30%,9/30)。胸腔内肿块可有不同程度的出血坏死、囊变6例(20%,6/30)。术前CT检查误诊率为26.7%(8/30),PET检查1例病理诊断为交界性SFTP的SUV值为2.0,另1例恶性SFTP的SUV值为3.8,术后病理诊断为交界性SFTP25例(73.3%,25/30),恶性SFTP为11例(26.7%,11/30)。结论 SFTP在螺旋CT检查上有一定的误诊率,PET/CT可望能在鉴别交界性和良性SFTP上发挥一定的作用,病理免疫组化CD34、Vim、Bcl-2等分子标记有助于诊断。Objective The aim of this paper is to study and evaluate the data of the patients with solitary fibrous tumor of the pleura （SFTP） operated in our institution with specific emphasis on its imaging findings and pathological features at our institution. Methods The records of 30 patients with the SFTP about the Imaging Findings and pathological features between 2004 and 2010 were analyzed retrospectively. Results Thirty patients （mean age 53 years, rang of 28-77 years old） were observed in this period. The imaging findings showed that the chest and mediastinum mass was the main performance within 19 patients （63.3%, 19/30）, different degrees of bleeding necrosis observed in 6 patients （20%, 6/30）.The Secondly main performance was pleural or wall nodule （30%, 9/30）. The misdiagnosis rate of the CT examination was 26.7% （8/30）. Two patients had PET/CT examination and the SUV value in 1 ease with the benign SFTP was 2.0 and the other malignant case was 3.8.The pathological diagnosis results showed that 25 cases （73.3% of 25/30）were benign and 1 patients （26.7%, 11/30） were malignant SFTP. Conclusion The spiral CT examinations for SFFP has the certain misdiagnosis rate and the PET/CT is expected to play a role in the differential diagnosis between the benign SFFP and the malignant case. The pathological diagnosis with immunohistochemical stain of CD34, Vim and Bcl-2 should be helpful to the diagnosis.

关 键 词：胸膜孤立性纤维瘤 影像学诊断 临床病理 免疫组化染色 

分 类 号：R734.3[医药卫生—肿瘤]