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目的探讨腹膜后间隙孤立性纤维性肿瘤(SFT)的CT表现及病理特征。方法回顾性分析7例经手术病理证实的腹膜后间隙SFT患者的CT表现及病理,包括良性SFT 3例,恶性SFT 3例,脂肪瘤型SFT 1例。男5例,女2例,平均年龄54.7岁。6例行平扫与增强,1例平扫。结果 (1)7例中,盆部腹膜外间隙4例,腹腔腹膜后间隙3例。(2)CT表现为肿块境界清楚,内部密度欠均匀,见多发灶性或不规则形稍低密度区;增强动脉期见迂曲扩张血管影,实性部分不均匀斑驳样强化,实质期强化较均匀,囊变坏死区无强化。恶性SFT 3例均伴有大面积出血、坏死。(3)病理表现为肿瘤细胞由梭形细胞组成,细胞间富有束状胶原纤维和分支状薄壁血管。免疫组织化学除1例恶性SFT的CD34及CD99阴性表达外,其余病例CD34、bcl-2、CD99、Vimentin均阳性表达。结论腹膜后间隙SFT的CT表现有一定特征但缺乏特异性,最终诊断需病理及免疫组织化学证实。
Objective To investigate the CT findings and pathological features of retroperitoneal solitary solitary fibrous tumors (SFT). Methods The CT findings and pathology of 7 cases of retroperitoneal clearance SFT confirmed by surgery and pathology were retrospectively analyzed. Among them, 3 cases were benign SFT, 3 cases were malignant SFT and 1 case was lipoma type SFT. 5 males and 2 females, with an average age of 54.7 years. 6 routine scan and enhancement, 1 case of plain scan. Results (1) 7 cases, 4 cases of extrapenetrative pelvic, abdominal peritoneal space in 3 cases. (2) CT showed a clear state of the mass, the internal density is not uniform, see the multifocal or irregular shape of a little low density area; arteries see tortuous dilation of blood vessels, uneven solid mottled like enhancement, the substantial enhancement Uniform, cystic necrosis no enhancement. Malignant SFT 3 cases were accompanied by large area bleeding and necrosis. (3) pathological manifestations of tumor cells by spindle cells, cells rich in bundles of collagen fibers and branches of the thin-walled blood vessels. Immunohistochemistry in addition to a case of malignant SFT CD34 and CD99 negative expression, the remaining cases were positive for CD34, bcl-2, CD99, Vimentin. Conclusion The CT findings of retroperitoneal space SFT have some characteristics but no specificity. The final diagnosis should be confirmed by histopathology and immunohistochemistry.