肝脏孤立性纤维性肿瘤1例

正患者男,41岁,反复上腹胀2个月。CT(图1):平扫显示肝右叶前下段类圆形肿块影,边界清楚,大小约7.54cm×6.91cm,呈不均匀性稍低密度,CT值30 HU,增强扫描动脉期病灶内可见少许明显强化血管影,肿块整体呈不均匀性轻度强化,CT值45HU,静脉期(CT值51HU)及延迟期(CT值68HU)进一步强化,整体呈不均匀性渐进性强化。MRI(图2):肿块T1WI呈稍低信号,其内可见斑片状更低信号,T2WI呈混杂高信号,可见斑片状或条索状低信号,T2WI压脂     

盆腔孤立性纤维性肿瘤1例

<正>患者男,52岁,因"肛门坠胀不适4月余,加重伴排便费力1周"入院。查体:右下腹压痛。直肠指检:骶前直肠下段右侧旁占位性包块。实验室检查:白蛋白37.91g/L,乳酸2.96mmol/L,氯112.20 mmol/L,二氧化碳17.00 mmol/L,B型尿钠肽116.17pg/ml,癌胚抗原1.54μg/L,糖类抗原CA19-9 7.84 U/ml。超声检查:盆腔见大小约9.11cm×8.37cm×7.64cm低回声团块,形状规整(图1A)。CT检查:右侧坐骨直肠窝至盆腔内     

气管孤立性纤维性肿瘤1例

正患者女,47岁,因"受凉后咳嗽、咳痰2周,咯鲜红色血痰1天"入院。气管镜检查:气管管腔内距气管隆突约2~3cm处见一新生物,约1.2cm×0.8cm,气管管腔近1/2被堵塞,表面有较多血性分泌物(图1A)。胸部CT:平扫见气管隆突前上方的气管左侧壁有一乳头状结节影,密度均匀,CT值61 HU,边缘光整,与相邻的气管壁呈窄基相连,气管壁未见异常;增强后肿块明显均匀强化(图1B),CT值201 HU,相邻的气管壁无明     

肾孤立性纤维瘤1例报告并文献复习

目的 分析肾孤立性纤维瘤的临床病理特征及诊治方式.方法 回顾性分析我院诊治的1例肾孤立性纤维瘤的病理特征、临床表现、影像学检查、治疗方式和术后随访状况.结果 肾孤立性纤维瘤是肾脏较罕见的一种间叶性肿瘤,良性居多,少数为恶性.病理特征多为VIM(+)、CD34(+)、BcL-2(+)、CD99(+).影像学检查显示为类圆形、包膜完整的肿物,与周围组织界限清楚,CT增强后呈现不同程度欠均匀强化.本例患者行机器人辅助腹腔镜下肾部分切除术,术后病理诊断为肾孤立性纤维瘤(中间性),术后随访3月余,未见肿瘤复发、进展和转移.结论 肾孤立性纤维瘤属临床上较罕见的肿瘤,确诊主要通过病理诊断,治疗上首选手术切除肿瘤.     

A locally aggressive solitary fibrous tumor of the leg: Case report and literature review

INTRODUCTIONThe solitary fibrous tumor (SFT) is a rare soft tissue tumor with a substantially benign clinical behavior. However, malignant neoplasms with local recurrence or distant metastases have been reported.PRESENTATION OF THE CASEThe authors present a case of an aggressive SFT of the leg, in a 55 years old Caucasian man. Radiological, histological and molecular findings are reported. The differential diagnosis, therapy and outcome of this rare tumor are also discussed.DISCUSSIONAn extensive review of literature showed SFT's clinical behavior as substantially benign, anyway aggressive or malignant neoplasms have been described. The potential risk of local recurrence and distant metastasis thus suggests wide surgical resection and careful long-term follow-up. Differential diagnosis may be quite laborious as SFT can mimic a variety of benign and malignant mesenchymal tumors; immunohistochemical analysis for CD34, CD99, vimentin and bcl-2 is then mandatory.CONCLUSIONOur clinical experience confirmed that SFT may have an aggressive behavior, however, conservative surgical treatment may be successful in the long term.     

第三脑室孤立性纤维性肿瘤/血管外皮细胞瘤1例

正患者女,54岁,7个月前无明显诱因出现双下肢无力,偶有头晕,无恶心、呕吐,3个月前发现记忆力下降;发病以来神志清、精神可,睡眠正常。MRI:第三脑室可见不规则斑片状混杂等长T1等T2信号,约36.6mm×41.5mm×49.2mm,病灶内见斑片状囊性长T1长T2信号,瘤周见多发流空血管影,双侧丘脑及中脑受压移位,内见斑片状稍长T2信号(图1A、1B);增强扫描病灶呈明显强化,囊性区无强化(图1C)。MRI诊断:脑     

Solitary fibrous tumor in the cervical spine with destructive vertebral involvement: a case report and review of the literature

Introduction  Recently, solitary fibrous tumors occurring in spine-related lesions have been reported. However, the destruction of vertebral bodies by this type of tumor has not been reported. Materials and methods  A 71-year-old female presented with pain from a mass on the right side of her neck. Plain radiographs of the cervical spine showed collapse of the C5 vertebral body and dislocation of the C4 vertebral body. The MRI image showed a large mass surrounding C4 and C5, which had low signal intensity in the T1W image and high signal intensity in the T2W image. At first, resection of the tumor and spinal fusion was performed by anterior approach. Results  Histology revealed a solitary fibrous tumor with proliferating spindle cells. Immunohistochemistry showed positive stains for vimentin and CD34. One year postoperatively, a local recurrence manifested extensive destruction of the C4 and C5 vertebral bodies. Then, palliative surgery with posterior cervical instrumentation and radiation therapy were performed. Because the destruction proceeded and the rods were broken 2 years after, she underwent additional occipito-cervical instrumentation. Conclusions  This is the first report of a solitary fibrous tumor that involves the destruction of the spinal structure. An extensive destruction of the vertebral body by the solitary fibrous tumor needs to be aware in treating this tumor with spinal involvement.     

肾孤立性纤维瘤1例报告并文献复习

目的提高对肾孤立性纤维瘤的认识,探讨其诊治方法。方法对1例肾脏孤立性纤维瘤患者临床资料进行分析,并结合文献复习。结果患者行左肾根治性切除术。病理诊断为肾脏孤立性纤维瘤。术后随访6个月无复发和转移。结论肾孤立性纤维瘤是一种较为罕见的肿瘤,诊断主要依靠组织病理学及免疫组织化学,手术切除为主要的治疗方法,术后需长期随访。     

Solitary fibrous tumor of the lung

Solitary fibrous tumors are mesenchymal entities integrated in a mixed group of hemangiopericytoma-like neoplasms. Although classically presented as a pleura-based mass, there are extrapleural sites including the lung. We present the clinical, imaging, and histological features of a solitary fibrous tumor of the lung.     

Solitary fibrous tumour of the liver: case report and review of the literature

Background Solitary fibrous tumours (SFTs) of the liver are very rare entities. Although firstly described to be tumours of pleural origin, SFTs have been reported in various organs such as the meninges, orbit, upper respiratory tract, thyroid, peritoneum, retroperitoneum and soft tissues. Histologically, this tumour often shows alternating cellular and relatively acellular areas. The cellular areas show a wide variety of patterns, making it difficult for it to be differentiated from other mesenchymal tumours. Its immunohistochemical positivity for CD34 and vimentin is believed to be unique. Histiogenesis of SFTs, however, is not yet fully understood. They are known to be usually benign, with only few reports indicating their ability to metastasize.Patients and methods We review the literature on SFTs of the liver and report on the case of a 63-year-old female patient with a large SFT of the right liver.Conclusions Surgical resection seems to be the treatment of choice. Local recurrence is scarce. Due to the very limited number of cases, data regarding the long-term survival of patients are lacking.     

Solitary fibrous tumor of the breast: A case report and the review of the literature

Solitary fibrous tumors (SFT) are rare mesenchymal neoplasms. They were first described as spindle‐cell tumors originating from the pleura, but they may arise in any anatomical site. SFT of the breast is an exceedingly rare clinical entity. Our literature review yielded only 21 cases reported so far. We describe a case of a SFT of the breast in a premenopausal patient who presented with a gradually enlarging palpable breast mass. Diagnostic evaluation and management are discussed along with a review of the relevant literature. There are no pathognomonic imaging findings of SFT of the breast. Complete surgical resection with clear margins is the gold standard of treatment. Thorough immunohistochemical analysis is crucial to obtain a definitive diagnosis. Although most SFTs run an indolent course, in some cases the clinical behavior can be unpredictable and a long‐term follow‐up for all patients is therefore mandatory.     

胸腔非典型孤立性纤维肿瘤1例

正患者男,43岁,2个月前无明显诱因出现胸闷、气促,偶有咳嗽、咳痰,近2天出现左侧胸痛。CT增强示左侧胸腔内下份见混杂密度肿块(图1),病灶中心层面大小约10.3cm×23.1cm,病灶与膈肌分界不清;增强后肿瘤呈不均匀强化。考     

肾窦孤立性纤维瘤1例

患者女,52岁,因"体检发现右肾窦肿瘤1年"入院。查体未见明显异常。实验室检查空腹血糖3.82mmol/L。CT:平扫见右肾窦不规则等低混杂密度肿块(图1A),边界清,大小约5.8cm×3.7cm×7.5cm,CT值约23~48 HU;增强扫描皮质期病灶不均匀强化(图1B),排泄期病灶强化程度增高、范围扩大(图1C),考虑乏脂型血管平滑肌脂肪瘤可能。于1周后行腹腔镜下根治性右肾切除术。     

Solitary fibrous tumor in the pelvic space

A case of a solitary fibrous tumor (SFT) of the pelvic space in a 64-year-old man is reported herein. Computed tomography (CT) of the pelvis showed a large mass enhanced heterogeneously left paracentral and posterior to the bladder and intimately associated with prostate. The site of origin of the mass could not be defined on CT because margins blended with the bladder, prostate, and rectum. A tumorectomy was performed and has remained well with no evidence of recurrence during the last 3 months. The tumor was 12.5×9.5×8.3 cm in size, solid with a fibromuscular capsule, and gray-tan in color. Histologically, the neoplasms were well circumscribed and composed of short spindle cells arranged without an obvious pattern. Immunohistochemically, these cells were strongly positive for CD 34 and negative for S-100, alpha SMA, and AE1/AE3.     

Solitary fibrous tumor of the perithyroidal soft tissue mimicking substernal goiter

Solitary fibrous tumor is an uncommon neoplasm. We present a case of solitary fibrous tumor of the perithyroidal soft tissue mimicking a substernal goiter.     

Solitary fibrous tumor of the thoracic spine

Intraspinal solitary fibrous tumors are rare: to our knowledge, the literature reports only 27 cases. We present a histologically and immunohistochemically confirmed solitary fibrous tumor involving the intradural extramedullary compartment of the thoracic spine. Microsurgical gross-total resection was achieved. A definitive role for adjuvant treatments in this type of tumor has not been established and therefore, they were not used. The patient was well, without clinical or radiological recurrence, 18 months after surgery.