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目的探讨颅内孤立性纤维瘤(solitary fibrous tumors,SFT)的病理及影像学表现,旨在提高对罕见颅内肿瘤的诊断与鉴别诊断。资料与方法回顾性分析经临床病理证实的2例SFT的病理及影像学表现。结果左顶部及小脑分叶状肿块各1例,CT平扫与脑灰质等密度,左顶部肿块周边见大片水肿。MRI平扫,T1WI与灰质等信号为主;左顶部肿块T2WI呈稍高信号,其内见多发“蚯蚓”状稍长T1、长T2信号,边缘见不完整的长T1、长T2信号环;左小脑肿块T2WI呈等、低信号,其内可见留空血管,增强扫描均明显强化,左顶部肿块内可见“蚯蚓”状强化更明显条状影,其边缘环形异常信号未见强化,近大脑镰处可见“脑膜尾征”。显微镜下瘤细胞呈梭形,束状或波纹状分布,瘤细胞间夹杂丰富的胶原纤维;免疫组织化学检查:波形纤维蛋白(Vim)(+),CD34(-)或(+)。结论颅内SFT的MRI表现有一定特征性,确诊需依靠病理组织学及免疫组织化学检查。
Objective To investigate the pathological and imaging findings of solitary fibrous tumors (SFT) in order to improve the diagnosis and differential diagnosis of rare intracranial tumors. Materials and Methods Retrospective analysis of pathological and imaging findings of 2 cases of SFT confirmed by clinical pathology. Results The top of the left and lobulation of the cerebellum in 1 case, CT scan and the density of gray matter, the top of the left top of the mass see large edema. MRI scan, T1WI and gray matter signals; the left top of the tumor T2WI showed a slightly higher signal, which see multiple “earthworm” shape slightly longer T1, T2 signal, the edge of incomplete T1, T2 signal Ring; left cerebrum mass T2WI was equal and low signal, which can be seen empty blood vessels, enhanced scanning were significantly enhanced, the left top of the mass visible “earthworm ” shape more obvious strip shadow, the edge of the ring abnormal signal was not seen Strengthen, near the falx visible at the “Meningeal sign.” The tumor cells were spindle-shaped, bundle-like or corrugated under the microscope. The tumor cells were rich in collagen fibers. Immunohistochemistry: Vim (+), CD34 (-) or (+). Conclusion MRI manifestations of intracranial SFT have some characteristics, diagnosis depends on histopathology and immunohistochemical examination.