4例胸膜孤立性纤维性肿瘤的CT表现及临床病理特征

摘要

Objective:To investigate the CT findings and clinicopathological features of solitary fibrous tumor of the pleura( SFTP). Methods:Clinical,radiological and pathological material of 4 patients from January 2012 to Au-gust 2014 were collected and analysed retrospectively. Literatures were reviewed. Results:Of the 4 patients,SFTP oc-curred in 2 men and 2 women. In 1 case it was associated with the partietal pleura and in 3 cases with the visceral pleura. In 1 case it connected with the visceral pleura by a peduncle. The enhanced CT scan revealed the giant tumor heterogeneous patchy enhancement and several enhanced vessels. Photomicrograph of the histopathologic specimen showed ovoid to spindle shape cells arranged haphazardly with strands of collagen tissues. Immunohistochemistry of the tumor cells showed positive staining for CD34,Melan-A,Vimentin,Ki-67 and negative staining for PCK,SMA,S-100,Desmin,CR,HMB45. Conclusion:SFTP is a kind of rare pleura origin tumor. The radiological features of SFTP is peculiar. It is necessary to make pathologic and immunohistochemical tests to make a definite diagnosis.%目的：探讨胸膜孤立性纤维性肿瘤的CT表现及临床病理特征。方法：收集胸膜孤立性纤维性肿瘤4例，对其临床、病理及影像学资料进行分析及文献复习。结果：本组病例男性2例，女性2例，来源于壁层胸膜1例，来源于脏层胸膜3例，有蒂状基底部结构1例。CT增强扫描显示巨大型肿瘤实质呈“地图样”强化，可见多支血管供血。病检镜下呈现富细胞区与疏松区相间分布，其中富细胞区由卵圆细胞、梭形细胞以及胶原纤维和血管组成，细胞呈束状、编织状或无序状排列，胞核长卵圆形，空泡状，核仁不明显。免疫组化染色CD34、Melan-A、Vimentin、Ki-67呈阳性表达，PCK、SMA、S-100、Desmin、CR、HMB45均呈阴性表达。结论：胸膜孤立性纤维性肿瘤是一种胸膜来源的少见肿瘤，影像学表现较特殊，确诊需要依靠病理学及免疫组织化学检查。