肺内单发结节性硬化性血管瘤：CT特征与病理相关性分析  

Pulmonary sclerosing hemangioma presenting as solitary nodule： CT findings and pathologic characteristics

作　　者：张国滨[1] 唐娟[2] 朱珠华[1] 

机构地区：[1]上海市第六人民医院 介入影像科 [2]上海市第六人民医院 病理科,上海200233

出　　处：《实用放射学杂志》2013年第1期32-35,44,共5页Journal of Practical Radiology

摘　　要：目的探讨单发结节性肺硬化性血管瘤（PSH）的CT表现及与病理的相关性．提高对PSH的认识。方法回顾性分析病理证实13例PSH的CT形态学及增强表现，对照大体、HE染色病理资料，并检测免疫组织化学指标CK，EMA，TTF-1，Ki-67，Des，SMA，S-100等表达。结果13例PSH均为女性，表现为肺内边缘光滑的单发结节，11例圆形或类圆形，2例有浅分叶，CT增强后明显强化（不均匀强化3例）．9例延时扫描缓慢廓清。2例见点样钙化，2例结节周边伴磨玻璃影。大体病理：12例肿瘤均与肺组织界面清楚．5有完整包膜；HE染色瘤内由海绵状血管瘤区（HE）、乳头区（PA）、实性区（SO）、硬化区（SC）混台构成，5例见似包膜。PA为主6例，HE为主4例，SO为主2例；12例Ki-67低度表达（〈1％）。结论肺内单发结节性PSH的CT常见形态表现为圆形或类圆形，边缘清楚，明显强化，周边可伴随磨玻璃影，或伴钙化，影像表现与组织病理特征卡珂关。Objective To investigate the CT and pathological characteristics of pulmonary sclerosing hemangioma （PSH）. Meth- ods The imaging features, pathological characteristics, and the immunohistochemical expression for 13 cases with PSH were retro- spectively analyzed. Results All the patients were female. All of lesions were solitary nodules with smooth margins. Eleven lesions presented as well-defined, round or oval shaped nodules on CT image; while 2 lesions were slightly lohulated. 11 cases showed a homogeneous soft-tissue mass on un-enhanced CT, and calcification was found in 2 cases. Ground glass opacity was observed around the nodule in 2 cases. All the lesions showed remarkable enhancement after contrast medium administration with slowly wash out in 9 cases on delayed-scan. Pathological morphology demonstrated PSH was composed of four types of migratory structures, including papillary, solid, sclerotic and hemorrhagic pattern. Six tumors had a predominantly papillary component, while 4 were hemangioma tous, and 2 were solid. The positive expression of CK, EMA and TTF-1, the markers of lung cancers （Des,SMA and S-100） were negative. The positive expressions of Ki-67 were rare in all cases. Conclusion The common morphologic features on CT present as well-defined, round or oval mass with marked contrast enhancement. CT features partly reflect the pathological characteristics. The immunoehemical characteristics of Ki-67 indicated PSH was a slowly growing benign tumor.

关 键 词：孤立性肺结节 肺硬化性血管瘤 计算机体层成像 病理学 

分 类 号：R734.2[医药卫生—肿瘤] R446.8[医药卫生—临床医学]