Abstract
Objective: To explore the clinical and radiographic characteristics, methods of diagnosis and treatment of solitary fibrous tumor of the pleura (SFTP). Methods: To retrospectively analyze the diagnostic process of 1 case of SFT patients with computed tomography (CT) presenting rib impression, and to have literature review. Results: The patients had obvious clinical symptoms. His chest CT showed a 3.4cm×2.4cm size round soft tissue density in the right upper chest wall outside pleura, the boundary between pleura and the image is not clear, adjacent rib showed traces of impression formation, enhanced scanning lesions was slightly uneven, range small patchy low enhancement. His pathological examination showed that the tumor tissue is mainly composed of spindle cells, and immunohistochemis- try showed CD34, CD99, SMA positive. Conclusions: SFTP is a rare spindle cell tumor, clinical manifestation and imaging are not specific. The pressure trace CT presented is not proprietary features of neurogenic tumors in the ribs. The diagnosis of SFTP mainly depends on the pathological and immunohistochemistry examination. Operation is the first choice of the treatment, and prognosis is good after the operation.
Highlights
[4] Poyraz A, Killc D, Hatipoglu A, et al Pedunculated solitary fibrous tumors arising from the pleura[J].Monaldi Arch Chest Dis,2006,65(3)
[5] Magdeleinal, P, Alifano M,Petino A,et al Solitary fibrous tumors of the pleura:clinical characteristics ,surgical treatment and outcome[J].Eur J Cardiothorac Surg,2002,21:1087-1093
Summary
Fibroma; Pleural tumor; Computed tomography; Immunohistochemistry; Differential diagnosis 【摘要】目的 探讨胸膜孤立性纤维性肿瘤(SFTP)的临床、影像学特征及诊治方法。方法 回顾性分析 1 例 CT 呈现肋骨 压迹的胸膜 SFT 的诊断过程,并复习有关文献。结果 该患者无明显临床症状;胸部 CT 示右侧后上胸壁胸膜外见一个约 3.4cm ×2.4cm 大小的类圆形软组织密度影,边界与胸膜分界不清,临近肋骨有压迹形成,增强扫描病灶强化稍不均匀,灶内可见 小斑片状低强化影;病理检查示肿瘤组织主要由梭形细胞组成,免疫组织化学示 CD34、CD99、SMA 阳性。结论 SFTP 是 一种少见的梭形细胞肿瘤,临床表现及影像学检查无特异性,CT 呈现肋骨压迹并非神经源性肿瘤的专有特征,诊断主要依 靠病理及免疫组织化学检查,手术治疗是首选的治疗方法,术后预后较好。 孤立性纤维性肿瘤(solitary fibrous tumor,SFT)是一种少见的间叶源性梭形细胞肿瘤,由 klemperer 和 Rabin 首次描述[1],曾称为“胸膜下纤维瘤”、“间皮下纤维瘤”和“局限性纤维性间皮瘤”等,国外文献 报道其发病率仅为 28/10 万,最常见的发病部位是脏层胸膜[2]。由于该病发现前常无明显症状,而在体检 或其他原因行放射线检查时发现,可见影像检查对指导下一步的诊治具有重要价值。CT 呈现肋骨压迹伴硬
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