胸膜孤立性纤维瘤影像学表现与病理学的临床对照研究  

Pathological and radiological characteristics of solitary fibrous tumor in clinic

作　　者：江开航 熊组江 陈家飞[2] 

机构地区：[1]重庆市第五人民医院放射科,重庆400062 [2]第三军医大学西南医院放射科,重庆400038

出　　处：《局解手术学杂志》2013年第3期257-258,261,共3页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的研究胸膜孤立性纤维瘤(SFTP)的影像学表现,并探讨影像学表现与病理临床表现的相关性。方法回顾性分析8例经手术病理证实的SFTP患者的影像学资料、临床表现及病理特征,分析影像学表现与病理、临床表现的相关性。结果SFTP影像学表现多与胸膜关系密切,肿瘤多呈类圆形或浅分叶改变;8例病灶,其中良性7例,CT表现为平扫密度欠均匀,边界清楚;增强扫描,5例呈不均匀延迟强化,2例密度均匀,增强扫描静脉期呈均匀中度强化;1例为恶性,肿瘤占据整个胸腔,密度不均,增强扫描呈明显不均匀性强化。本组8例患者中,以低血糖为首发症状的7例,3例患者有不同程度的胸闷、胸痛,1例无任何临床症状。HE染色提示胸膜孤立性纤维瘤由梭形细胞组成,呈细胞丰富区和稀疏区分布,胞浆红染,核圆形、卵圆形。免疫组化:CD34、Vimentin均为阳性。结论 SFTP常以低血糖、胸痛、胸闷为首发症状;肿瘤多位于胸膜,类圆形,增强扫描常有不同程度的延迟强化。瘤体主要由梭形细胞组成,CD34、Vimentin为阳性。Objective To summarize the radiological characteristics of solitary fibrous tumor（sFrP） ,the correlation of imaging findings and pathology was analyzed. Methods The radiological and pathological characteristics of solitary fibrous tumor were analyzed,and the corelation in between imaging findings and pathological manifestations were retrospectively analyzed in eight cases with SFTP. Results SFTP was always closely related to the pleura, oval or scallop-shaped contour. Seven cases of those lesions were benign tumors, which displayed heterogeneous density and clear boundary. Five cases showed a delayed enhancement at CT enhancement scanning. Two cases showed a homogeneous density and uniformity enhancement in venous phase. One case lesion was malignant ,which showed an inhomogeneous density and heterogeneous enhancement. Seven cases were presented with hypoglycemia as the initial symptom, three case showed chest tightness and chest pain in varying degrees and one case without any clinical symptom. HE stain showed that the tumors mostly were consisted of spindle cells, with cell-rich and cell-sparse regions, the cytolymph was red, and the nucleolus was round or oval. Positive immunohistoehemical staining：CD34 and Vimentin. Conclusion SFTP generally present with hypoglycemia,chest tightness and chest pain as the initial symptom. Imaging findings showed that the tumor which located the pleura was circular, which showed a delayed enhancement after enhanced. The tumor is consisted of spindle cells. And CD34 and Vimentin are positive.

关 键 词：孤立性纤维瘤 影像表现 体层摄影术 病理学 低血糖 

分 类 号：R734.3[医药卫生—肿瘤] R814.42[医药卫生—临床医学]