肾脏孤立性纤维瘤影像诊断

目的:探讨肾脏孤立性纤维瘤的病理及影像学表现,提高对少见肾脏肿瘤的诊断与鉴别诊断.方法:回顾手术病理证实的2例肾孤立性纤维瘤影像学和病理学表现.结果:2例肾肿瘤均起自肾实质并突入肾盂,大小分别为2cm和3cm;在CT平扫时均表现为略高密度软组织肿块,边缘清楚锐利,增强后有轻中度强化.其中1例行MRI检查,T2WI上肿块与肾实质比为明显低信号.病理学表现:境界清、质硬的肿块,切面灰白或黄白色有漩涡和编织状结构,形态类似子宫的平滑肌瘤.显微镜下孤立性纤维瘤可见成纤维细胞样细胞交错缠绕在一起伴大量的胶原纤维沉积,成蟹足样.免疫组织化学CD34强阳性.结论:肾孤立性纤维瘤罕见,其由于纤维组织致密造成CT上肿瘤密度较肾实质高,在MRI的T2WI上肿瘤为低信号表现,有助其诊断与鉴别诊断.

Imaging Diagnosis of Solitary Fibrous Tumor of the Kidney:Report of Two Cases and Review of the Literature

Objective:To explore the pathologic and imaging features of solitary fibrous tumor of the kidney (SFTK) so as to improve the diagnostic accuracy of this rare renal tumor.Methods:The imaging and pathology data of 2 patients with surgically and pathologically proved SFTK were reviewed.Results:Imaging appearance: Both lesions presented as sharply defined masses of slightly high density within renal parenchyma with intrusion into renal pelvis.Mild to moderate enhancement was noted on enhanced CT images Low signal intensity on T2WI was seen in the case underwent MR.Pathologic appearance:Both lesions were well circumscribed and composed of a mixture of spindle cells and dense collagenous bands and no necrosis or cystic changes.Immunohistochemical study revealed positive CD34 staining in both cases.Conclusion:SFTK may present as a mass of slightly high density on CT and low signal intensity on T2WI.