纵隔孤立性纤维性肿瘤的CT 表现及其误诊分析  

CT characteristics of solitary fibrous tumor of the mediastinum and analysis of 5 misdiagnosed cases

作　　者：李家言[1] 高春萍[1] 袁文昭[1] 欧海玲[2] 李敏[1] 

机构地区：[1]广西中医药大学第一附属医院放射科,广西南宁530023 [2]广西中医药大学第一附属医院病理科,广西南宁530023

出　　处：《实用放射学杂志》2014年第6期930-932,共3页Journal of Practical Radiology

摘　　要：目的：探讨纵隔孤立性纤维性肿瘤的 CT 表现,分析影像学误诊的原因。方法回顾性分析经手术病理证实的5例纵隔孤立性纤维性肿瘤的 CT 表现,全部病例术前 CT 检查均误诊。结果5例中,3个肿块主体位于右侧纵隔内,呈椭圆形,边缘清晰,可见“胸膜尾征”；2个病灶主体位于右侧胸腔内,边缘不清,压迫邻近肺组织；肿瘤直径8.6-15 cm,中位数为11.5 cm；密度不均匀,CT 增强后肿块呈不均匀、“地图”样强化。结论 CT 能明确纵隔孤立性纤维性肿瘤的大小、形态及邻近结构,确诊仍依赖于病理学及免疫组化检查；对本病缺乏足够认识是术前误诊的主要原因。Objective To investigate CT features of solitary fibrous tumor of the mediastinum（SFTM）,and to analyze the causes of misdiagnosis of this disease.Methods CT features of 5 patients of SFTM confirmed operatively and pathologically were retrospectively analyzed.All patients underwent before operation but were misdiagnosed.Results 3 cases were located in right mediastinum with oval-shap,well-defined margin,and “pleural tail sign”,2 cases were located in right thoracis cavity with unwell-defined margin, and in the adjacent lung were oppressed.In all 5 patients,the mean median of tumors was 1 1.5 cm（8.6-1 5 cm）,non-homogeneous density of tumors were seen on plain CT scans,and obvious non-homogeneous enhancement with“geographic pattern”on contrast-enhanced CT.Conclusion CT can clearly reveal the size and the appearance of SFTM,adjacent architectures,the final diagnosis depends on histopathological and immunohistochemical findings of the tumors.To un-know is the main caused of misdiagnosis of medi-astinal SFT.

关 键 词：孤立性纤维性肿瘤 纵隔 计算机体层成像 

分 类 号：R734.5[医药卫生—肿瘤] R814.42[医药卫生—临床医学]