【摘要】 目的:探讨胸膜孤立性纤维瘤(solitary fibrous tumor of the pleura,SFTP)的影像学特征,以提高对该病的认识。方法:回顾性分析经手术病理证实的15例SFTP患者,13例行CT平扫及增强检查(其中1例同时行MRI检查),另外2例仅行MRI检查。分析肿瘤大小、形态、密度或信号、强化方式及其与周围结构的关系。结果:15例均为边界清晰的孤立性肿块,10例呈类圆形或椭圆形,5例呈分叶状。CT平扫以等密度为主,密度均匀或不均匀。2例内见钙化。MRI T1WI呈等低信号,T2WI呈等偏高信号,扩散加权成像(diffusion weighted imaging,DWI)呈高信号。增强扫描均呈渐进性延迟强化,6例明显强化,9例轻至中度强化,6例肿块内见肿瘤血管。4例出现"胸膜尾征",12例肿瘤推压周围肺组织形成条带状高密度影。光学显微镜下见分化良好的梭形细胞散布于细长的胶原纤维之间,梭形细胞核分裂少见。免疫组织化学检测结果显示,Vimentin+(7/8)、CD34+(8/8)、Bcl-2+(5/8)。结论:SFTP可表现为边界清楚的孤立性肿块,体积较大,动态增强扫描呈延迟强化的影像学特征,可为临床提供诊断依据。更多还原

【Abstract】 Objective: To investigate the radiologic and pathologic characteristics of solitary fibrous tumor of the pleura(SFTP). Methods: A total of 15 cases of SFTP confirmed by surgery and pathology were retrospectively analyzed. Thirteen cases underwent plain and enhanced CT scanning(one underwent MRI scanning at the same time), and 2 cases underwent MRI scanning only. The location, size, shape, density or signal intensity and enhancement pattern of the tumors were studied. Results: All the 15 cases presented solitary masses with well-defined margin, among which 10 were round or oval-like and 5 were lobulated. Most of the masses showed iso-attenuation on plain CT with homogeneous or heterogeneous density, and 2 with calcification. Iso-or hypointense on T1 WI, Iso-or hyperintense on T2 WI, hyperintense on diffusion weighted imaging(DWI) were shown. After the administration of contrast agent, all of the tumors presented gradually delayed enhancement pattern. Six tumors manifested obvious enhancement, 9 tumors showed mild or moderate enhancement, and 6 tumors had affluent tumor vessel. Four cases showed "pleura tail sign", and 12 cases showed that surrounding lung tissues were pushed to form a strip with high density. Microscopically, these tumors consisted of whorls of reticulin and collagen with interspersed spindle-shaped cells, without significant nuclear division. Immunohistochemical analysis showed that Vimentin(+)(7/8), CD34(+)(8/8), Bcl-2(+)(5/8). Conclusion: SFTP can be expressed as an isolated mass with well-defined margin, lager size and delayed enhancement pattern after enhancement, which can be used as clinical evidence for its diagnosis.更多还原