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胸膜纤维瘤(孤立性纤维性肿瘤):一种形态多样的疾病。从我们的病例中选取的临床、组织学及非典型放射学表现

Fibrous tumour of the pleura (SFTP): a proteiform disease. Clinical, histological and atypical radiological patterns selected among our cases.

作者信息

Cardinale L, Cortese G, Familiari U, Perna M, Solitro F, Fava C

机构信息

Istituto di Radiologia, Università degli Studi di Torino, Ospedale San Luigi Gonzaga, Regione Gonzole 10, 10143, Orbassano, Italy.

出版信息

Radiol Med. 2009 Mar;114(2):204-15. doi: 10.1007/s11547-008-0345-7. Epub 2008 Dec 11.

Abstract

First described by Klemperer and Rabin in 1931, solitary fibrous tumour of the pleura (SFTP) is a mesenchymal tumour that tends to involve the pleura, although it has also been described in other thoracic areas (mediastinum, pericardium and pulmonary parenchyma) and in extrathoracic sites (meninges, epiglottis, salivary glands, thyroid, kidneys and breast). SFTP usually presents as a peripheral mass abutting the pleural surface, to which it is attached by a broad base or, more frequently, by a pedicle that allows it to be mobile within the pleural cavity. A precise preoperative diagnosis can be arrived at with a cutting-needle biopsy, although most cases are diagnosed with postoperative histology and immunohistochemical analysis of the dissected sample. SFTP, owing to its large size or unusual locations (paraspinal, para-mediastinal, intra-fissural and intraparenchymal), can pose interpretation problems or, indeed, point towards a diagnosis of diseases of a totally different nature. We present some unusual radiographic and computed tomography (CT) images of large SFTP or SFTP located in atypical thoracic locations in patients who underwent surgical resection.

摘要

胸膜孤立性纤维瘤(SFTP)于1931年由克莱姆佩雷尔和拉宾首次描述,是一种间叶性肿瘤,倾向于累及胸膜,不过在其他胸部区域(纵隔、心包和肺实质)以及胸外部位(脑膜、会厌、唾液腺、甲状腺、肾脏和乳腺)也有相关报道。SFTP通常表现为紧贴胸膜表面的外周肿块,通过宽基底或更常见的蒂附着于胸膜,使其能够在胸腔内移动。尽管大多数病例是通过对切除样本进行术后组织学和免疫组化分析来诊断的,但通过切割针活检也可得出准确的术前诊断。由于SFTP体积较大或位置特殊(脊柱旁、纵隔旁、叶间裂内和实质内),可能会带来解读难题,甚至指向完全不同性质疾病的诊断。我们展示了一些接受手术切除的患者中大型SFTP或位于非典型胸部位置的SFTP的异常影像学和计算机断层扫描(CT)图像。

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