Department of Diagnostic and Interventional Radiology, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany,
Insights Imaging. 2014 Apr;5(2):237-44. doi: 10.1007/s13244-013-0306-0. Epub 2014 Jan 10.
To describe the computed tomography (CT) features in a case series of primary intrathoracic extracardiac malignant mesenchymal tumours (sarcomas).
A 5-year retrospective research was conducted, and 18 patients were selected. CT exams were reviewed by two chest radiologists, blinded to tumour pathological type, origin and grade. Lesions were described in relation to location, size, shape, margins, enhancement, presence of cavitation, calcifications, ground glass component, intratumoural enhanced vessels, pleural effusion, pleural tags, lymphangitis, chest wall/rib involvement and pathological lymph nodes.
The readers described five pulmonary, six mediastinal and seven pleural/wall based lesions. Mean largest diameter was 103 mm. The most frequent shape was irregular (n = 12), most predominant margin was smooth (n = 12) and enhancement was mostly heterogeneous (n = 8). Intratumoural vessels and pleural effusion were seen in 11 patients. Pathological lymph nodes were present in four cases and calcifications in two cases.
Some frequent radiological features were described independently of tumour location and subtype. A sarcoma should be included as a major differential diagnosis when the radiologist faces an intrathoracic mass of large size (>70 mm) but with well defined smooth or lobulated margins, especially if presenting intratumoural vessels, associated pleural effusion but no significant lymphadenopathy.
• Malignant mesenchymal tumours (sarcomas) are rare and can arise from any structure in the chest. • Intrathoracic sarcomas show some frequent radiological features, independent of location and type. • Some CT features may help the radiologist suspect for a sarcoma instead of other more common tumours.
描述一组原发性胸腔心脏外恶性间叶肿瘤（肉瘤）的计算机断层扫描（CT）特征。
进行了一项为期 5 年的回顾性研究，共选择了 18 名患者。两名胸部放射科医生对 CT 检查进行了评估，他们对肿瘤的病理类型、起源和分级均不知情。根据位置、大小、形状、边缘、强化、空洞形成、钙化、磨玻璃成分、肿瘤内增强血管、胸腔积液、胸膜赘生物、淋巴管炎、胸壁/肋骨受累和病理性淋巴结等方面对病变进行了描述。
读者描述了五个肺部、六个纵隔和七个胸膜/胸壁病变。最大直径平均值为 103mm。最常见的形状为不规则（n=12），最常见的边缘为光滑（n=12），强化最常见为不均匀（n=8）。11 例患者可见肿瘤内血管和胸腔积液。4 例患者存在病理性淋巴结，2 例患者存在钙化。
无论肿瘤位置和亚型如何，一些常见的影像学特征都可以独立描述。当放射科医生面对大小较大（>70mm）但边界清楚、光滑或分叶状的胸腔内肿块时，尤其是存在肿瘤内血管、伴发胸腔积液但无明显淋巴结病时，应将肉瘤作为主要鉴别诊断之一。
恶性间叶肿瘤（肉瘤）罕见，可起源于胸部任何结构。
胸腔内肉瘤具有一些常见的影像学特征，与位置和类型无关。
一些 CT 特征有助于放射科医生怀疑为肉瘤，而不是其他更常见的肿瘤。
