肺原发恶性纤维组织细胞瘤的CT征象分析  

CT features of primary pulmonary malignant fibrous histiocytoma

作　　者：王传卓[1] 刘兆玉[1] 

机构地区：[1]中国医科大学附属盛京医院放射科,辽宁沈阳110004

出　　处：《中国临床医学影像杂志》2014年第5期336-339,共4页Journal of China Clinic Medical Imaging

摘　　要：目的：提高对肺原发恶性纤维组织细胞瘤（MFH）CT表现的认识。材料与方法：回顾性分析15例经手术病理或穿刺活检证实的肺原发MFH患者的临床资料及CT表现。结果：15例肺原发MFH患者中，周围型肿瘤12例，位于左叶7例，右叶5例；中心型3例。12例单发，3例多发，共20个病灶，肿瘤最大直径为3.5～15.4 cm，平均8.5 cm。12个病灶为类圆形，8个呈浅分叶状。14个病灶边界较清楚，6个边界不清。5个病灶CT平扫表现为等密度；15个密度不均，内可见坏死、囊变、出血及钙化。增强扫描12例17个病灶均有不同程度强化。病变侵犯胸膜及胸壁6例（其中3例侵蚀到肋骨），侵犯肺动脉、肺静脉各1例，侵犯心包2例，肺门、纵隔淋巴结转移5例，远处转移4例。结论：肺原发MFH的CT表现具有一定的特征性，有助于对该病的诊断，最终确诊需依靠病理细胞学及免疫组织化学。Objective： To identify CT characteristics of primary pulmonary malignant fibrous histiocytoma （MFH）. Materials and Methods： CT images and clinical data of 15 patients with primary pulmonary MFH proved pathologically were reviewed and analyzed retrospectively. Results： Among 15 patients, MFH appeared as peripheral lesions in 12 cases, located in left lobe 7 cases, right lobe 5 cases and central 3 cases. A total of 20 lesions were identified, in which 12 had single lesion and 3 had mutiple lesions, with mean a diameter of 8.5 cm and ranged between 3.5-15.4 cm, including 12 round-shaped and 8 mild lobulated lesions. Among all the 20 lesions, 14 were well-defined and the others had unclear border, while 5 masses were homogenous in density and the other 15 were inhomogenous with necrosis, cysts, bleeding or calcification. Twelve patients underwent enhanced CT, 17 lesions had various degress of enhancement in arterial phase and venous phase. Six lesions involved pleura and chest wall （among which 3 involved ribs）, 1 involved pulmonary artery, 1 involved pulmonary vein, 2 involved pericardium, as well as 5 metastasis on pulmonary hilar or mediastinat lymph node, 4 distant metastasis. Conclusion： Primary pulmonary MFHs have some specific CT manifestations which are helpful to the diagnosis, but final diagnosis depends on the cytopathology and immunohistoehemistry.

关 键 词：肺肿瘤 肿瘤 纤维组织 体层摄影术 螺旋计算机 

分 类 号：R734.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]