Objective To discuss the pathological and CT manifestations of intra-abdominal invasive fibromatosis (IAF). Methods CT imaging and histopathological features of 2 cases of invasive fibromatosis confirmed by surgical pathology were retrospectively analyzed. Moreover,the related literature was reviewed. Results Two cases were both single lesion. One case occurred in small mesenteric. The plain CT scan showed saccate or solid mixed density and the enhanced CT scan showed the the gradual strengthening of solid part. The lesion invaded neighboring small intestine and the transverse colon,in which multiple pneumatosis were seen. Another one was located in the serosa of middle segment of small intestine. The plain CT scan showed that the density of lesion was slightly lower than that of the soft tissue of abdominal wall and the enhanced CT scan showed that the strengthening exhibited slight delay,with no clear boundary between adjacent small intestine and lesions,in which low density area with unclear boundary can be seen. Routine pathology showed that the tumor was composed of spindle cells like fibroblasts and arranged in a fascicular or wavy arrangement. Immunohistochemistry showed that the expressions of vimentin and β-catenins-100 were positive and Desmin was negative. Conclusion CT findings of IAF have certain characteristics,which are closely related to their pathological characteristics. Nevertheless,the definitive diagnosis is established by pathological and immunohistochemical features.%目的 探讨腹内型侵袭性纤维瘤病(IAF) 的病理及CT影像特征.方法 结合文献回顾性分析经手术病理证实的2例侵袭性纤维瘤病的CT影像表现及组织病理学特征.结果 2例病灶均为单发,1例位于小肠系膜,平扫呈囊实性混杂密度,增强实性部分渐进性强化,侵犯邻近小肠及横结肠,病灶内见多发积气; 另1例位于小肠中段浆膜面,平扫密度略低于腹壁软组织,增强轻度延迟强化,与邻近小肠分界不清,病灶内有大片边界不清之低密度区.病理: 肿瘤由纤维母细胞样的梭形细胞构成,呈束状或波浪状排列; 免疫组化: vimentin 阳性,β-catenin 阳性,S-100 阴性、Desmin 阴性.结论 IAF的CT表现有一定的特征性,且与其病理特点密不可分,最终诊断有赖病理及免疫组化.
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