孤立性纤维性肿瘤的影像及病理分析  

Pathological features and imaging analysis of solitary fibrous tumors

作　　者：崔艳秋[1] 俞咏梅[1] 窦彤[1] 过永 CUI Yan-qiu YU Yong-mei DOU Tong GUO Yong(Medical Imaging Center, the First Affiliated Hospital of Wannan Medical College, Wuhu Anhui 241001, China)

机构地区：[1]皖南医学院第一附属医院弋矶山医院医学影像中心,安徽芜湖241001

出　　处：《中国临床医学影像杂志》2017年第4期250-254,共5页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨孤立性纤维性肿瘤(SFT)的影像表现及病理特征。方法:回顾性分析经病理证实的19例SFT的影像资料,并与病理结果对照分析。结果:(1)19例均为单发,发生于胸膜8例,肾门3例,颅内2例,胸壁、肺、盆腔、颈肩部、腰背部及颌下区各1例,其中1例病理诊断为恶性;病灶最大径3~15 cm;病灶多呈类圆形或不规则形的实性软组织肿块,边界清楚,部分见分叶。(2)CT检查16例,4例密度均匀,12例不均匀,其中5例伴钙化;多期增强扫描多呈"快进慢出"型不均匀强化。MRI检查3例,T_1WI多呈等或稍低信号,T_2WI呈等、低或稍高为主的混杂信号,增强后明显不均匀强化。病灶内部及周围可见肿瘤血管。(3)镜下:肿瘤由疏密不均短梭形细胞、胶原纤维及薄壁血管组成。结论:SFT可发生于全身多部位,影像表现有一定特征,但最终确诊仍需依赖于病理学与免疫组织化学检查。Objective： To investigate the imaging manifestations and pathological features of solitary fibrous tumors. Methods： The imaging data of 19 cases with solitary fibrous tumor confirmed by pathology were retrospectively analyzed and compared with the corresponding pathological results. Results： ①All of the 19 cases had single lesion, 8 cases occurred in the pleura, 3 in the renal hilum, 2 in the central nervous system, and the wall of the chest, lung, pelvic cavity, neck and shoulders, the back of the lumbar and the submandibular region each had 1 case occurred; One case among them was malignant. The tumors ranged from 3-15 cm in maximum diameter. The tumors were mostly quasi-circular or oval or irregular solid soft tissue masses with clear boundary, some of them were lobulated. ②In the 16 cases of CT examination, 4 lesions showed homogeneous density, 12 lesions showed heterogeneous density, 5 cases of which had calcification; Most of the lesions showed uneven enhancement; The multiphase scanning type is “fast in and slow out”. Three patients underwent MRI. Most of the lesions showed equal or slightly low signal on T1WI, mixed signal on T2WI. The lesions were obviously enhanced on enhanced T1WI. Histologically, the tumor were formed with hyper-and hypo-cellular spindle cells, dense collagenous fibers and thin-walled blood vessels. Conclusion： SFT can occur in many parts of the body and the imaging manifestations have certain characteristics. The final diagnosis still needs pathological and immunohistochemical examination.

关 键 词：纤维瘤 体层摄影术 螺旋计算机 磁共振成像 

分 类 号：R73[医药卫生—肿瘤] R814.42[医药卫生—临床医学]