摘要
目的:探讨孤立性纤维瘤的临床病理学和影像学表现及良恶性孤立性纤维瘤的鉴别。方法:回顾性分析经术后病理确诊的18例孤立性纤维瘤的影像学表现,并与病理学结果进行对照。结果:2例为孤立性纤维瘤术后复发或转移患者,3例经病理学诊断为恶性孤立性纤维瘤。X线摄片和多层计算机断层摄影术(multi-slicecomputed tomography,MSCT)影像表现为软组织肿块影,肿瘤大多呈类圆形或分叶状;除1例恶性孤立性纤维瘤部分边界不清外,其余肿瘤的边界均较清晰;肿瘤内部密度均匀或欠均匀。磁共振成像T1WI呈现较均匀的等信号,T2WI呈现为高或略高信号中混杂低信号,肿瘤内部可见蚯蚓状流空血管影。增强扫描显示肿瘤呈中-重度渐进性不均匀强化,肿瘤内部及周围可见丰富的供血动脉。免疫组织化学结果:CD34表达阳性18例,Bcl-2表达阳性17例,S100表达阴性15例,vimentin表达阳性17例,cytokeratin表达阴性18例,desmin表达阴性18例;15例良性孤立性纤维瘤的Ki-67表达阳性比例均<5%,3例恶性孤立性纤维瘤的Ki-67表达阳性比例均>5%。结论:孤立性纤维瘤影像学表现有其特征性,包括丰富的供血动脉、特征性T2WI信号、增强后肿瘤不同成分的强化方式等,均有助于鉴别诊断。确诊及鉴别良恶性孤立性纤维瘤有赖于病理学和免疫组织化学结果。
Objective： To investigate the clinical and pathological features and imaging manifestations of SFT （solitary fibrous tumor）, and further to define the differiciation between the benign and malignant SFTs. Methods： The imaging findings were retrospectively analyzed and compared with the corresponding pathological results in 18 patients with SFT confirmed pathologically. Results： Of the 18 patients, 2 had postoperative recurrent or metastatic tumor, 3 had malignant SFT. The X-ray and MSCT （multislice computed tomography） scan images showed oval or Iobulated masses with discrete margins except one malignant tumor. The tumor density was clear or nearly uniform. MRI （magnetic resonance imaging） examination showed that the tumors had intermediate signal intensity on TlWl （Tl-weighted image） and heterogeneous signal intensity with flow voids on T2Wl （T2-weighted image）. All tumors showed heterogeneously intermediate or intense enhancement with geographic pattern. Intralesionally and paraleisonally prominent feeding vessels could be seen. The results of immunohistochemistry demonstrated that CD34 was positive in 18 patients; Bcl-2 and vimentin were positive in 17 patients;S100 was negative in 15 patients; cytokeratin and desmin were negative in 18 patients; Ki-67 expression was less than 5% in 15 benign tumors and more than 5% in 3 malignant tumors. Conclusion： There are some specific imaging featurewhich are helpful to the differential diagnosis for SFT. These specific imaging features include the rich feeding vessels, the signal intensity on T2Wl and the different enhancements associated wLth the tissue compositions of the tumor. However, making a definitive diagnosis still depends on pathology and immunohistochemistry.
出处
《肿瘤》
CAS
CSCD
北大核心
2013年第5期454-459,共6页
Tumor
关键词
孤立性纤维瘤
计算机体层摄影术
磁共振成像
X线
诊断
Solitary fibrous tumor
Computed tomography
Magnetic resonance imaging
X-ray
Diagnosis
