中国临床医学影像杂志
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外周型原发性肺滑膜肉瘤的CT特征及文献复习
汪国余,王  彬,黄抒佳,徐祖良,吴玉林 
浙江台州市中心医院 台州学院附属医院放射科,浙江 台州  318000
CT features of peripheral type of primary pulmonary synovial sarcoma and literature review
WANG Guo-yu, WANG Bin, HUANG Shu-jia, XU Zu-liang, WU Yu-lin
Department of Radiology, Taizhou Central Hospital, Affiliated Hospital of Taizhou College, Taizhou Zhejiang 318000, China
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摘要 目的:探讨外周型原发性肺滑膜肉瘤(Primary pulmonary synovial sarcoma,PPSS)的CT表现和临床特点,提高对该病的认识,为临床诊治提供依据。方法:回顾分析6例经病理证实外周型PPSS的临床资料及CT影像特点,6例患者均行胸部CT平扫加增强扫描,其中3例进行了薄层重建,并复习相关文献。结果:6例患者中男1例,女5例,平均年龄47.2岁,病理证实均为单向型肺滑膜肉瘤;2例单发,4例病灶多发,共计12个病灶,10个呈圆形或类圆形,2个病灶形态不规则;8个病灶边界清,4个边界模糊,侵犯胸壁或胸膜;7个病灶密度不均,内伴液化坏死,不均匀强化,其大小均值约70.3 mm,另5个病灶密度均匀,未见液化坏死区,病灶大小均值约30.8 mm,两组数据存在显著统计学意义(P=0.005<0.05);所有病灶内均未见钙化灶。平扫及增强双期扫描病灶实性部分CT值平均约46.8 HU、70.7 HU及93.4 HU;5个病灶内见血管征。4例患者伴有胸水,其中2例胸水密度偏高。1例伴右肺门及食管旁淋巴结增大。结论:外周型PPSS一般病灶较大,肿瘤大时容易液化坏死,实性部分轻中度持续强化改变,胸部增强CT有一定的提示意义,特别是当肿瘤多发或合并胸腔积液密度增高时,需要进行鉴别诊断。
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汪国余
王 彬
黄抒佳
徐祖良
吴玉林
关键词 肺肿瘤肉瘤滑膜体层摄影术螺旋计算机    
Abstract:Objective: To investigate the CT findings and clinical features of peripheral type of primary pulmonary synovial sarcoma(PPSS). Methods: The clinical data and CT imaging characteristics of 6 cases with pathologically-proved peripheral type of PPSS were retrospectively analyzed. All 6 cases received con-contrast scan and enhanced chest scan with spiral CT, and 3 cases underwent multiplanar reconstruction. Results: Of the 6 cases, 1 case was male and 5 cases were female, with an average age of 47.2 years, all the cases were single phase type of synovial sarcoma confirmed by pathology. There were 2 cases with single lesion and 4 cases with multiple lesions, a total of 12 lesions, 10 of which were circular or quasi-circular, 2 of which were irregular shape, 8 of which had clear boundaries, and 4 of which had blurred boundaries, invading the chest wall or pleura. The density of 7 lesions was uneven, accompanied by liquefaction necrosis and uneven enhancement, with an average size of 70.3 mm. The density of the other 5 lesions was even, with no liquefaction necrosis area, with an average size of 30.8 mm, the two groups were statistically significant(P=0.005<0.05). No calcification was found in all lesions. The CT values of the solid part of the lesion in plain scan and enhanced dual-phase scan were about 46.8 HU, 70.7 HU and 93.4 HU. Vascular signs were found in 5 lesions. Four patients were accompanied by pleural effusion, 2 of which had high pleural effusion density. One patient was accompanied by enlargement of right hilum and para-esophageal lymph nodes. Conclusion: Peripheral type of PPSS usually has large lesions, and when the tumor is larger, it is easier to liquefy necrosis, and the part of solid was mild to moderate continuous enhancement in enhanced CT imaging. Enhanced CT has certain significance, especially when the tumor is multiple or the pleural effusion density is increased, differential diagnosis is needed.
Key wordsLung neoplasms    Sarcoma, synovial    Tomography, spiral computed
收稿日期: 2019-11-27     
PACS:  R734.2  
  R814.42  
通讯作者: 汪国余,浙江台州市中心医院 台州学院附属医院放射科,318000。E-mail:75101094@qq.com   
作者简介: 汪国余(1981-),男,安徽黄山人,副主任医师。E-mail:75101094@qq.com
引用本文:   
汪国余,王 彬,黄抒佳,徐祖良,吴玉林 . 外周型原发性肺滑膜肉瘤的CT特征及文献复习[J]. 中国临床医学影像杂志, 2020, 31(6): 414-417.
WANG Guo-yu, WANG Bin, HUANG Shu-jia, XU Zu-liang, WU Yu-lin. CT features of peripheral type of primary pulmonary synovial sarcoma and literature review. JOURNAL OF CHINA MEDICAL IMAGING, 2020, 31(6): 414-417.
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http://www.jccmi.com.cn/CN/10.12117/jccmi.2020.06.009     或     http://www.jccmi.com.cn/CN/Y2020/V31/I6/414
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