目的：探讨肺上皮样血管肉瘤的CT表现，提高对该病的诊断和鉴别诊断能力。方法回顾性分析6例经手术、穿刺及病理证实的原发性肺上皮样血管肉瘤的CT表现，术前均做CT检查。结果6例肿瘤灶最大径2．4～9．8 cm，CT平扫密度不均匀，1例伴有结节状钙化，增强扫描6例肿瘤均呈不均匀强化，见坏死区；3例出现肺门、纵隔淋巴结转移。5例表现为病灶同侧胸膜广泛不均匀增厚、受侵犯，胸腔少－中量积液，胸廓不同程度塌陷；1例胸膜局限性牵拉、增厚、受侵。免疫组织化学结果显示6例CD34、CD31、Vimentin均为阳性。结论肺上皮样血管肉瘤在CT上呈恶性肿瘤表现，胸膜广泛性增厚和受侵犯／转移、伴有胸腔积液是其常见表现，确诊需要依靠病理、免疫组化检查。%Objective To analyze the CT features of pulmonary epithelioid angiosarcoma (PEA). Methods The clinical records and CT of 6 patients with pathologically confirmed PEA were retrospectively analyzed. Results CT showed maximum tumor diameter of 2.4-9.8 cm with heterogeneous density (6), nodular calcification (1), heterogeneous enhancement and necrosis (6), hilar and mediastinal lymph node metastasis (3). Pleural invasion was manifested as extensive uneven thickening of the ipsilateral pleurawith pleural effusion, varying degree oflung collapse (5), limited pleural traction and thickening (1). Immunohistochemistry showed CD34, CD31 and Vimentin staining in all 6 tumors. Conclusions CT shows malignant features with extensive pleural thickening, effusion, invasion or metastasis in PEA. Histological and immunohistochemical examination is required for diagnosis.
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