肺孤立性纤维瘤CT征象与病理对照分析  

Compared analysis of CT features and pathology of pulmonary solitary fibrous tumor

作　　者：张雪梅[1] 李邦国[1] 曾令雯[1] 王梦[1] 吴硕 程念岚 罗显丽 ZHANG Xuemei;LI Bangguo;ZENG Lingwen;WANG Meng;WU Shuo;CHENG Nianlan;LUO Xianli(Department of Radiology ,the Affiliated Hospital of Zunyi Medical University ,Zunyi563003,China)

机构地区：[1]遵义医学院附属医院影像科,贵州遵义563003

出　　处：《实用放射学杂志》2018年第12期1857-1859,共3页Journal of Practical Radiology

基　　金：国家自然科学基金项目(81460265).

摘　　要：目的探讨肺孤立性纤维瘤(SFT)的CT征象及其病理基础,提高对SFT的CT诊断及鉴别诊断水平。方法回顾性分析14例经手术病理证实的肺SFT的CT表现,并与病理资料对照分析。结果14例肺SFT中,病变位于右肺6例,左肺8例,肿块最大径2.5~20.Ocm,>10.Ocm者6例。CT平扫14例均表现为形态不规则实性结节或肿块,4例边界不清,1例可见分叶。增强扫描多呈不均匀强化,渐进性强化。光镜下肿瘤组织主要由不同程度增生的梭形细胞及胶原纤维构成,3例可见异型细胞,细胞间质血管丰富。13例患者进一步行免疫组化:Vimentin、BcI一2、CD99均为阳性,CD34阳性9例。结论肺SFT的CT表现由其病理基础决定,CT对肺SFT的定位及定性诊断有重要价值。如果CT发现肺内单发软组织团块,增强扫描不均匀渐进性强化,呈“地图样”改变,应考虑SFT的可能。Objective To compare the CT features and pathology of pulmonary solitary fibrous tumor (SFF),to improve the diagnosis and differential diagnosis.Methods CT images and corresponding pathological results of 14cases with pulmonary SFF were analyzed retrospectively. Results Among the 14cases,6were in the right lung and other 8were in the left.The maximum diameters of tumors were ranged from 2.5cm to 20.0cm,and 6cases were over 10.0cm.All 14cases represented as irregular solid nodule or mass,4as unclear boiandary and 1as lohulation.Most of the cases showed heterogeneous and progressive enhancement.The light microscopy showed that tumor tissues were mainly composed of collagen fibers and spindle cells with different proliferation degrees,and 3cases showed atypia cells.There were abundant blood vessels in the intercellular substance.Immunohistochemistry were done in 13cases,presenting Bcl-2,CD99and Vimentin positive expressions in all cases and CD34expression in 9.Conclusion The CT features of pulmonary SFT are related to pathological features.CT scan is important in the localization and qualitative diagnosis of pulmonary SFT,and obvious inhomogeneous map-like and progressive enhancement should be considered for the diagnosis of SFT.

关 键 词：肺 孤立性纤维瘤 计算机体层成像 病理学 

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