摘要
目的探讨肺纤维平滑肌瘤型错构瘤(PLH)患者的CT影像表理与病理对照分析。方法回顾性分析经手术及病理证实的14例PLH患者的CT影像学资料,并与相应病理结果进行对比分析。结果14例患者接受CT检查。单发9例:其中7例呈混杂密度肿块影,边缘光滑,纵隔内未见明显肿大淋巴结,增强扫描病灶明显不均匀强化,2例示肺野单发结节灶,边缘毛糙,可见短细毛刺影;多发5例,双肺散在多发圆形结节状病灶,密度均匀,边界清,最大长径为5.9 mm。增强扫描病灶不均匀强化。14例病理结果均为良性,镜下观察:组织学上边界清楚,见分化成熟的纤维平滑肌组织大量增生呈束状、交织状及旋涡状结构,瘤细胞核细长,两端钝圆,胞质略嗜酸性。在梭形纤维平滑肌细胞之间有衬覆着立方或矮柱状上皮的腺管状及裂缝状结构;部分上皮细胞显示杯状细胞化生,无明显异型性,未见核分裂像;未见软骨、黏液、脂肪等间叶成份。结论CT成像能显示肿瘤的大小、范围及周围临界组织的解剖关系,但缺乏特异性,明确诊断仍有赖于病理检查。
Objective To study the CT appearance and pathology of pulmonary fibroleiomyomatous hamartoma(PLH).Method CT imaging data of 14 PLH patients confirmed by operation and pathology were analyzed retrospectively,and compared with the corresponding pathological results.Results All the 14 cases were examined by CT.9 cases of them were single,mixed density mass shadow occurred in 7 cases,with smooth edge,there was no obvious enlarged lymph node in mediastinum,the focus showed obviously uneven enhancement under the enhanced scanning;there were 2 cases of single nodule focus in lung field,with rough edge,and there was short fine bristle shadow.5 cases of them were multiple,with scattered multiple round nodule focus in bilateral lung,uniform density,clear edge,and the maximum length was 5.9 mm.The focus showed uneven enhancement under the enhanced scanning.The pathological results of 14 cases were all benign.Microscopic observation showed that the histologic boundary was clear,and a large number of well-developed fibrous smooth muscle tissue proliferated in bundles,interwoven,and whirlpool structure.The tumor cell nucleus was long and thin,the two ends were blunt and round,and the cytoplasm was slightly eosinophilic.There were glandular tubes and crevices between the fusiform smooth muscle cells lined with cuboidal or short columnar epithelium.Some epithelial cells showed goblet cell metaplasia without obvious heteromorphism or mitosis.No cartilage,mucus,fat,or other interlobular components were found.Conclusion CT imaging can show the size and range of tumor and the anatomic relationship of surrounding critical tissue,but it is lack of specificity.The definite diagnosis still depends on pathological examination.
作者
王新强
王永广
李军
Wang Xinqiang;Wang Yongguang;Li Jun(Department of Radiology,Shizhong District People's Hospital,Zaozhuang 277100,China)
出处
《国际医药卫生导报》
2020年第5期714-716,共3页
International Medicine and Health Guidance News
