肺原发恶性纤维组织细胞瘤的影像表现

探讨肺原发恶性纤维组织细胞瘤（ＭＦＨ）的影像特点,提高术前确诊率。方法对本院７例及文献中４４例共５１例影像资料进行分析。包括胸片５１例,ＣＴ９例及ＭＲＩ１例。结果本院肺原发ＭＦＨ占同期肺癌０．０１％。全组发病中位年龄５５岁。主要症状为咳嗽、血痰及胸痛。随诊４０例中,死因不明５例,复发和（或）转移１５例,复发率为４２．８％（１５／３５）,发生在一年内占８０．０％。肿瘤位于右叶３４例,左叶１７例。周围型４９例,占９６．１％;中心型２例,占３．９％。影像表现：肿瘤呈软组织肿块,瘤体较大,≥５ｃｍ者３５例,占６８．６％。形态呈规则或不规则形。边缘光整或界限清者２９例,占５６．９％;伴有分叶者２２例,占４３．１％;密度均匀者３３例,占６４．７％。少数病灶边缘有毛刺、囊性变及空洞形成。ＣＴ显示病变密度低且有坏死区,周围组织器官受侵。结论肺原发ＭＦＨ的影像表现虽无特征,但瘤体大,边界清,少分叶,少毛刺,密度低,可有别于常见的肺癌和良性肿瘤。ＣＴ及ＭＲＩ检查有助于显示病变内部密度、侵犯范围和转移情况,可提高诊断率。本病变恶性度高,复发转移快,根治切除可有长期生存的可能

Imaging findings of malignant fibrous histiocytoma in the lung

Objective To show the characteristic findings of the image of primary malignant fibrous histocytoma (PMFH) in the lung. Methods Fifty one cases of pulmonany PMFH were reviewed, 7 from our hospital and 44 from the literature including chest radiograms 51 cases; CT scans 9 cases and MRI 1 case. Results Primary MFH comprises 0.01% of all pulmonany malignant tumors seen in the same period. The mean age was 55 years. The most common complaints were cough, hemoptysis and chest pain. In 40 cases who were followed, recurrence/metastasis developed in 42.9% with 80% appearing within one year. The sites of the lesion were: right lobe in 34 cases and left lobe in 17 cases. It was peripheral in 49 (96.1%) cases and central in 2 (3.9%). The finding of the image was a large solitary mass (>5 cm, 68.6%) with regular or irregular margin. Most of the tumors were well circumscribed (56.9%) or lobulated (43.1%) showing homogeneous attenuation (64.7%). Cystic changes or cavitation was observed in a few cases. On CT, the lesion shows low attenuation and involves the adjacent structures. Conclusion PMFH gives images which are not pathognomonic. Yet, its regular, well defined border, less lobulated configuration could differentiate itself from the common malignant and benign lesionsin the lung. CT and MRI can provide useful information in demonstrating the nature and extent of invasion of the tumor.