【摘要】 目的 探讨恶性孤立性纤维瘤（malignant solitary fibrous tumors,MSFT）的影像及病理学表现,以提高对MSFT诊断水平。方法 回顾性分析5例经手术病理证实的MSFT的影像学表现,并与病理学进行对照。结果 5例MSFT中,发生于胸腔内2例,左侧颞部皮下软组织、左肾旁及胃窦处各1例。4例MSFT体积巨大,形态不规则,1例体积较小,呈椭圆形;2例边界清楚,有包膜,3例与周围软组织分界不清。1例行MRI扫描,信号均匀,呈等T₁稍长T₂信号改变,增强扫描呈中度均匀强化。4例行CT检查,密度不均,增强扫描呈明显不均匀强化;1例有肺部转移,1例手术切除后复发。病理:5例HE染色均见一定异型性的梭形细胞及病理性核分裂象;免疫组化CD34、Vimentin和ki-6均为阳性。结论 MSFT缺乏特征性影像表现,误诊率高,病理学及免疫组织化学诊断是确诊MSFT的金标准。更多还原

【Abstract】 Objective To investigate the imaging feature of malignant solitary fibrous tumor（MSFT）,so that to improve the knowledge and diagnostic accuracy of MSFT.Methods imaging features of five patients with MSFT confirmed by pathology were reviewed retrospectively and comparatively with the pathological findings.Results Among the five cases,the lesions located in chest in 2,left temporal subcutaneous soft tissue,gastric antrum and left para-kidney in one case,respectively.The tumors presented huge masses with irregular shape in four cases,small round mass in one,well-margina ted shape with capsule in 2 and ill defined border in3.On MRI,the lesion in obe case was homogeneous signal,hypointensity on T₁ WI and slight hyperintensity on.T₂ WI,and moderate marked homogeneous on contrast-enhanced scan.On CT,the lesions in four cases presented heterogeneous attenuation and heterogeneous enhancement,one case was metastatic to the lung,one cases recurred after the resection.The pathological findings showed high mitotic activity and polymorphism in all the five cases.Positive vimentin,CD34 and ki-67 were assessed on immunochemistry staining.Conclusion MSFT are not of significant imaging characteristics,final diagnosis should be based on histopathology and immunohistochemistry examinations.更多还原