肺部炎性肌纤维母细胞瘤16例患者的CT表现及病理分析

目的探讨肺部炎性肌纤维母细胞瘤(IMT)的CT表现及病理特点。方法回顾性分析经手术病理证实的16例肺部IMT患者的CT影像资料,并与临床病理对照。结果 16例均为单发病灶,11例位于右肺,5例位于左肺,均未见跨叶现象。CT影像学显示形态以不规则形为主,5例边缘光滑,11例边缘欠光整。7例密度不均匀,9例密度均匀;增强扫描显示均有不同程度的强化。4例可见少量积液影,4例钙化影,3例淋巴结肿大。镜下观察可见梭形细胞呈编织状或束状排列,间质内可见大量浆细胞、淋巴细胞、嗜酸性细胞浸润,免疫组化检查以波形蛋白Vimenrin、平滑肌肌动蛋白SMA阳性为主。结论肺部IMT表现多样,对疾病定性诊断有一定价值,但确诊仍需依靠临床病理和免疫组化检查。

CT Findings and Pathological Analysis of 16 Cases with Pulmonary Inflammatory Myofibroblastoma

Objective To investigate the CT findings and pathological characteristics of pulmonary inflammatory myofibroblastoma (IMT). Methods CT imaging data of 16 patients with IMT confirmed by surgery and pathology were analyzed retrospectively and were compared with clinical pathology. Results All 16 cases were single lesions, including 11 cases located in the right lung, and 5 cases in the left lung. There was no cross lobe. CT imaging showed irregular shape, 5 cases with smooth edges and 11 cases with not finishing edges. Density of 7 cases was inhomogeneous while of 9 cases was homogeneous. Enhanced scan showed varying degrees of enhancement. There was small amount of effusion shadow in 4 cases, calcification shadow in 4 cases and lymph node enlargement in 3 cases. Microscopic observation showed that the spindle-shaped cells were woven in shape or distributed in sarciniform. There was large number of interstitial plasma cells, lymphocytes and eosinophils infiltration. Immunohistochemical examination mainly showed vimentin (Vimenrin) and positive smooth muscle actin (SMA). Conclusion Pulmonary IMT has a variety of manifestations. It is of certain value in the qualitative diagnosis of the disease, but the final diagnosis still depends on the clinical pathological and immunohistochemical examination.