胸膜孤立性纤维性肿瘤的CT表现及病理学特征  

CT Features and Pathological Findings of Solitary Fibrous Tumor of the Pleura

作　　者：李浩亮[1] 孙希文[1] 杨春燕[2] 李蕴玉[1] 尤小芳[1,2] 

机构地区：[1]同济大学附属上海市肺科医院影像科 [2]新疆石河子市人民医院影像中心

出　　处：《中国医学计算机成像杂志》2016年第3期222-226,共5页Chinese Computed Medical Imaging

摘　　要：目的：探讨胸膜孤立性纤维性肿瘤（SFT）的CT征象及病理学特点。方法：回顾性分析34例经手术病理证实的胸膜SFT的CT及病理学资料。结果：CT上SFT均表现为胸腔内单发的软组织结节或肿块,最大径1.2-18.9cm,平均6.8±5.2 cm;18例肿瘤密度均匀,16例密度不均匀;3例见瘤内钙化,9例见瘤内增粗扭曲血管,3例见瘤旁供血血管;2例瘤周胸膜明显增厚,邻近肋骨压迫吸收、皮质硬化2例。病理显示肿瘤大体呈类圆形或分叶状;镜下瘤细胞呈梭形,间质大量胶原纤维沉积。免疫组化34例CD34、Bcl-2、Vimentin均表现为阳性。最终29例确诊为良性SFT,5例为恶性SFT。结论：胸膜SFT病理形态多样,富含梭形细胞和胶原纤维,CD34多阳性表达,其CT表现有一定特征,有助于术前诊断。Purpose： To evaluate the CT characteristics and pathological findings of the solitary fibrous tumor of the pleura（SFTP）. Methods： CT imaging and pathological data of 34 patients with SFTP confirmed by pathology results after operation were analyzed retrospectively. Results： The CT images demonstrated solitary soft-tissue mass in the thoracic cavity with the largest diameter ranged from 1.2 to 18.9 cm. The CT attenuation of the tumors was homogeneous in 18 cases and heterogeneous in 16. Calcification or tortuous vessels were seen in 3 and 9 cases respectively,and aberrant feeding artery was seen in 3 cases. Regular or irregular pleura thickening（n=2） and rib erosion（n=2） were also seen. Pathology results showed that the tumor was generally round or lobulated,and the tumor cell was spindle under microscope,with abundant interstitial collagen deposition. CD34,Bcl-2 and Vimentin were positive in all the cases. Twenty-nine cases were diagnosed as benign SFT,and 5 as malignant. Conclusion： SFTP shows morphological diversity in pathology,and rich in spindle cells and collagen fiber,with CD34 positive expression. Its CT features have certain characteristics,which are helpful for the diagnosis.

关 键 词：孤立性纤维性肿瘤 胸膜 CT 病理学 

分 类 号：R734.3[医药卫生—肿瘤] R730.44[医药卫生—临床医学]