CAJ | 학술논문

目的探讨孤立性纤维瘤(SFT)的影像学特点、临床表现和病理学特征.方法回顾性分析27例经病理确诊的SFT患者的影像学表现、临床特征和病理学表现.结果 27例SFT中,发生于胸部18例,腹部4例,腰骶部1例,盆腔3例,左肩后部1例.恶性8例,良性17例,交界性2例.CT扫描23例,均见包膜,其中16例良性SFT为边界清楚的类圆形肿块,大部分密度均匀,与周围组织分界清楚;6例恶性SFT边界不清,与周围组织粘连或侵犯周围组织,密度不均匀;1例交界性SFT边界清楚,与周围组织分界清楚,可见蛋壳样钙化.MRI扫描4例,肿瘤边界清楚,信号欠均匀,T1WI序列呈等或略高于肌肉组织信号,T2WI序列呈稍高信号,其中恶性SFT中可见不规则坏死区.27例SFT在增强扫描时均呈不均匀强化,强化程度不一,呈中至重度强化.免疫组化检查结果显示,CD34(+)22例,占81.5%;Vimentin(+)27例,占100.0%;CD99(+)27例,占100.0%;bcl-2(+)26例,占96.3%;CK(-)27例,占100.0%;S-100(-)26例,占96.3%.结论 SFT的影像学表现具有一定的特征性,病理形态学及免疫组织化学检查可以明确诊断.CT和MRI可以对SFT进行明确的定位,确定肿瘤与周围组织的关系,为手术切除提供帮助.
목적 탐토고립성섬유류(SFT)적영상학특점、림상표현화병이학특정.방법 회고성분석27례경병리학진적SFT환자적영상학표현、림상특정화병이학표현.결과 27례SFT중,발생우흉부18례,복부4례,요저부1례,분강3례,좌견후부1례.악성8례,량성17례,교계성2례.CT소묘23례,균견포막,기중16례량성SFT위변계청초적류원형종괴,대부분밀도균균,여주위조직분계청초;6례악성SFT변계불청,여주위조직점련혹침범주위조직,밀도불균균;1례교계성SFT변계청초,여주위조직분계청초,가견단각양개화.MRI소묘4례,종류변계청초,신호흠균균,T1WI서렬정등혹략고우기육조직신호,T2WI서렬정초고신호,기중악성SFT중가견불규칙배사구.27례SFT재증강소묘시균정불균균강화,강화정도불일,정중지중도강화.면역조화검사결과현시,CD34(+)22례,점81.5%;Vimentin(+)27례,점100.0%;CD99(+)27례,점100.0%;bcl-2(+)26례,점96.3%;CK(-)27례,점100.0%;S-100(-)26례,점96.3%.결론 SFT적영상학표현구유일정적특정성,병리형태학급면역조직화학검사가이명학진단.CT화MRI가이대SFT진행명학적정위,학정종류여주위조직적관계,위수술절제제공방조.
Objective To investigate the imaging features, clinical manifestations and pathological characteristics of solitary fibrous tumors ( SFT). Methods The clinicopathological manifestations and medical imaging findings were analyzed retrospectively in 27 patients with surgically confirmed SFT . Results The SFTs originated from different parts of the body, including 18 in the chest, 4 in the abdomen, 1 in the lumboscral area, 3 in the pelvis, and 1 in the left shoulder. Twenty-three cases were found by CT scan,among which there were 16 benign diseases, presented with well-defined round or elliptic margins, with homogeneous attenuation and clearly surrounding; 6 malignant cases with unclear demarcations, invasive surrounding, heterogeneous attenuation due to calcification and/or irregular necrosis, and 1 junctional case with well-defined margins, which was enlarged during follow-up. There were 4 SFTs scanned by MRI with clear margin and homogeneous or heterogeneous signal intensity. All of the 4 cases were isointense or hyperintense to muscle on T1-weighted images, and were hyperintense on the T2-weighted images. All tumors showed heterogeneously intense enhancement with geographic pattern. Immunohistochemical staining showed that CD34-positive was 81.5% , vimentin (100.0% ), CD99 (100.0% ) and bcl-2 (96. 3% ), as well as negative CK (100. 0% ) and S-100 (96. 3% ). Conclusion The location of SFT is varying.Though its clinical manifestations vary, the diagnosis is depended on pathology and immunohistochemistry.There are certain specific features related to SFTs on CT or MRI. These imaging techniques may serve to provide helpful information as to the location and vicinal anatomic structure of the tumor, which is of substantial importance for planning surgery.