论文部分内容阅读
目的探讨胸膜孤立性纤维性肿瘤(SFTP)的诊断及治疗方法。方法回顾9例胸腔肿瘤手术切除后病理确诊为SFTP的病例,就其诊断和治疗方法进行分析。结果 9例中,6例有咳嗽胸闷等症状,1例伴有严重低血糖,2例无明显症状体检发现。CT检查表现为包膜完整光滑的类圆形阴影,可伴有胸腔积液。术中探查肿瘤8例位于脏层胸膜,1例位于壁层胸膜。手术完整切除肿瘤,合并肺楔形切除1例,肋骨部分切除1例。肿瘤最大直径3～30cm。镜下SFTP由大量梭形细胞构成,间质含有大量粗细不等的胶原纤维。免疫组化结果 CD34阳性率为100%,Bcl-2阳性率为83.3%。结论早期SFTP大多无明显症状,诊断比较困难。压迫症状及低血糖症状的出现,应当高度怀疑SFTP。CT检查是重要的诊断手段。手术切除肿瘤是治疗SFTP的最好方法。确诊有赖于病理及免疫组织化学检查。
Objective To investigate the diagnosis and treatment of pleural solitary fibrous tumor (SFTP). Methods Nine cases of thoracic tumors were retrospectively analyzed and pathologically diagnosed as SFTP. The diagnosis and treatment methods were analyzed. Results Of the 9 cases, 6 had symptoms of cough and chest tightness, 1 had severe hypoglycemia, and 2 had no obvious symptoms. The CT examination showed a perfectly smooth, rounded, round-shaped shadow that could be associated with pleural effusion. Intraoperative exploration of tumor in the visceral pleura in 8 cases, 1 case located in the parietal pleura. Surgical complete resection of the tumor, combined with pulmonary wedge resection in 1 case, partial rib resection in 1 case. The largest tumor diameter 3 ~ 30cm. Microscopic SFTP consists of a large number of spindle cells, the interstitium contains a large number of different thickness of collagen fibers. Immunohistochemical results CD34 positive rate was 100%, Bcl-2 positive rate was 83.3%. Conclusion Most of the early SFTP no obvious symptoms, the diagnosis is more difficult. Compression symptoms and hypoglycemic symptoms should be highly suspected of SFTP. CT examination is an important diagnostic tool. Surgical resection of the tumor is the best way to treat SFTP. Diagnosis depends on the pathology and immunohistochemistry.