气管恶性纤维组织细胞瘤伴肺内转移一例

气管恶性纤维组织细胞瘤伴肺内转移一例张文朱春贤杜传国徐宝良恶性纤维组织细胞瘤（ＭＦＨ）是一种少见的恶性肿瘤，气管内的ＭＦＨ笔者未见报道。我们遇到１例，现图１气管内可见２ｃｍ椭圆形肿物，使气管呈偏心缝隙样狭窄图２气管内肿物镜下所见，成纤维细胞样细胞呈车...     

肺原发恶性纤维组织细胞瘤1例报告

恶性纤维组织细胞瘤(MFH)可发生于全身软组织，原发于肺的恶性纤维组织细胞瘤(PMFHL)极为少见，误诊率较高。最近我们收治PMFHL1例，现报告如下：     

肝内原发性恶性纤维组织细胞瘤的CT诊断（1例报道及文献复习）

恶性纤维组织细胞瘤(malignant fibrous histiocytoma,MFH)是发生率仅次于平滑肌肉瘤的软组织肉瘤[1],多发生于四肢、躯干和腹膜后区,转移和术后复发率较高,转移至肝脏的较常见[2],但原发于肝脏的仅见个案报道[3,4].现就本院1例经手术证实的肝脏原发恶性纤维组织细胞瘤及既往文献报道,做一综合性分析.     

原发性肺恶性纤维组织细胞瘤一例

原发性肺恶性纤维组织细胞瘤一例陶正龙，张福琛肺恶性纤维组织细胞瘤（ｍａｌｉｇａｎａｎｔｆｉｂｒｏｈｉｓｔｉｏ－ｃｙｔｏｍａ，ＭＦＨ）较少见，笔者曾遇１例，报告如下。患者女，４８岁。因刺激性咳嗽３个月，吐白色泡沫痰，带少量血丝并伴低热１个月入院。体检无...     

十二指肠恶性纤维组织细胞瘤一例

恶性纤维组织细胞瘤（MFH）是常见的软组织恶性肿瘤，可发生在身体的任何部位．最常见于四肢、躯干和腹膜后，其次为头颈部，极少发生在肺内，其他部位更为罕见。国内外文献仅见个案报道。     

肺部恶性纤维组织细胞瘤的CT及MRI表现

目的 探讨肺部恶性纤维组织细胞瘤的CT、MRI特征.方法 回顾性分析5例经手术病理证实的肺部恶性纤维组织细胞瘤患者的影像学资料,3例行CT,2例行MR检查.结果 4例来自于肺内,其中2例呈边缘明显强化方式,1例强化不明显,1例呈不均匀强化,2例侵犯周围组织,3例纵隔淋巴结转移,1例远处转移,2例有囊变、液化坏死、出血改变,2例肿瘤T1WI、T2WI上均呈中等不均匀信号,可见液化、坏死、出血.1例来自于胸膜,表现为胸壁下多发结节,边界清楚.结论 恶性纤维组织细胞瘤的影像学表现具有多样性,CT和MRI对于肺部恶性纤维组织细胞瘤的定位、病变范围及周围组织侵犯情况的评价具有重要价值.     

肺恶性纤维组织细胞瘤1例报告

纤维组织细胞瘤是好发于软组织的肿瘤。良性为多,恶性占1％左右。近年来,陆续有原发于骨的恶性纤维组织细胞瘤(简称MFH)的报道。而原发于肺的MFH极少。最近我们发现一例原发于肺的MFH,现报道如下。     

腹膜后恶性纤维组织细胞瘤CT诊断

目的：探讨腹膜后恶性纤维组织细胞瘤（MFH）CT表现及诊断价值。材料和方法：回顾性分析12例经手术或活检病理证实的后腹膜恶性纤维组织细胞瘤的临床和CT检查资料。结果：12例中，肿块平均最大径9．2cm，10例肿块形态不规则伴明显分叶，2例表现为椭园形。平扫CT值低于肌肉软组织10例，2例呈等密度或稍高密度，9例实质内明显坏死囊变，2例实质内可见钙化灶，3例破坏骨骼，1例累及肾脏，1例累及胰体、尾部。增强扫描肿块呈中－高度强化。对照手术病理结果，CT定位准确率75％，定性准确率41．67%。结论：腹膜后恶性纤维组织细胞瘤（MFH）CT表现为一定特征性，有助于协助临床诊断。     

骨恶性纤维组织细胞瘤的CT诊断(附11例报告)

目的：探讨骨恶性纤维组织细胞瘤的ＣＴ表现及其诊断价值。方法：对１１例手术病理证实的骨恶性纤维组织细胞瘤的ＣＴ表现进行回顾性分析。结果：１１例骨恶性纤维组织细胞瘤的基本ＣＴ表现为（１）溶骨性骨破坏，可呈地图样、虫蚀样或无结构的溶骨性破坏。（２）软组织肿块，范围大于溶骨病变，软组织块内可见钙化点。（３）患骨破坏区呈膨胀性改变。结论：Ｘ线平片仍是检出骨肿瘤的首次检查主要手段，但ＣＴ通常能更清晰显示骨和软组织的解剖和病理结构细节，象肿瘤大小、范围、形状、轮廓、密度、钙化、坏死等，因此，ＣＴ在诊断骨恶性纤维组织细胞瘤上具有重要价值     

骨恶性纤维组织细胞瘤（附20例报告及国内43例分析）

恶性纤维组织细胞瘤亦称纤维黄色肉瘤，是近年来方被认识的一种软组织肉瘤，1964年O‘Brien氏（1）等首先提出恶性纤维组织细胞瘤这一种病变（简称MFH）。1972年Feldman氏（2）首先报道原发于骨的MFH。目前国外文献已报道140余例（3）。国内自198年以来先后有许多报道，共有23例（4－10），我们亦得见20例，共43例，兹就其临床，X线作一综合分析。     

周围型浸润性肺腺癌EGFR基因突变与CT征象及病理的相关性

目的：探讨周围型浸润性肺腺癌表皮生长因子受体(EGFR)基因突变状态与 CT 征象及病理特征的相关性。方法收集193例经病理证实为周围型浸润性肺腺癌的手术标本,采用扩增阻滞突变系统对所有标本行 EGFR基因突变检测,结合胸部 CT征象及病理资料进行回顾性分析。结果193例中EGFR基因突变率为62.2%(120/193)。在CT征象方面：基因突变组与野生型组于横轴位上肿瘤最大直径(Dmax)分别为(2.52±1.01)cm和(3.11±1.34)cm,差异有统计学意义(P<0.05)。受试者工作特征曲线(ROC)提示Dmax=2.01 cm为判断 EGFR基因突变状态的最佳诊断阈值,敏感度与特异度分别为79%和64%。含磨玻璃密度影(GGO)的肿瘤突变率为78.0%,高于无 GGO 者(56.6%),P<0.05。肿瘤不伴有囊腔样改变者突变率为65.5%,高于伴有囊腔样改变者(40.0%),P<0.05。磨玻璃影/肿瘤直径比(G/T)、分叶征、毛刺征、胸膜凹陷征、血管集束征、空气支气管征、空泡征与EGFR基因突变率无显著相关性(P值均>0.05)。在病理特征方面：组织学亚型中以贴壁生长为主型突变率为77.5%,高于其他亚型(58.2%),P<0.05。以实体生长为主型突变率为26.3%,低于其他亚型(66.1%),P<0.05。无淋巴结转移者突变率为66.9%,高于淋巴结转移者(50.9%),P<0.05。结论在周围型浸润性肺腺癌中,部分CT征象及病理特征对于辅助预测 EGFR基因突变状态具有一定价值。     

Primary pulmonary malignant fibrous histiocytoma mimics pulmonary artery aneurysm with partial thrombosis: various radiologic evaluations

Primary pulmonary malignant fibrous histiocytoma (MFH) is very rare, so only a few imaging features have been reported. We report one case of rapidly growing primary pulmonary MFH mimicking a partially thrombosed pulmonary artery aneurysm and its radiologic findings, including multidetector row computed tomography (MDCT), conventional angiography, and fluorodeoxyglucose-positron emission tomography CT ([18F] FDG-PET/CT). On multi-phasic MDCT, this mass mimicked a pulmonary artery aneurysm with partial thrombosis. However, pulmonary artery aneurysm was excluded and suggested as a hypervascular parenchymal mass by subsequent conventional angiography. On [18F] FDG-PET/CT, it was a highly metabolic mass, showing a maximal standard uptake value (SUV) 12.1. Although primary pulmonary MFH is very rare and has no specific imaging findings, our experience might be helpful to differentiate a hypervascular pulmonary mass.     

Metastasis of the gastrointestinal tract: FDG-PET imaging

We assess the usefulness of F-18-fluoro-deoxyglucose (FDG) positron emission tomography (PET) in the evaluation of gastrointestinal metastases. Four cases (five lesions) in which metastases from three lung cancers and one malignant fibrous histiocytoma (MFH) of the femur were found in the gastrointestinal tract were reviewed (men/women 3 : 1, age 63–78 years, mean 72 years). The five lesions were duodenal, jejunal metastasis, and two stomach metastases from lung carcinoma, and rectal metastasis from MFH of the femur. FDG-PET was unable to detect small masses, but it was able to detect unforeseen lesions such as gastrointestinal metastases because FDG-PET is a whole-body scan in a single-operation examination. FDG-PET imaging provided valuable information for the diagnosis of gastrointestinal metastasis.     

Malignant fibrous histiocytoma metastatic to the thyroid gland

Despite frequent cancer metastases to the thyroid gland demonstrated at autopsy, finding of thyroid metastasis in clinical practice is rare. Malignancies most commonly metastasizing to the thyroid are malignant melanoma and carcinoma of the breast, kidney, and lung. Very little is known about thyroid metastases caused by sarcomas. Of these, malignant fibrous histiocytoma (MFH) is one of the most common in adults, with a high rate of metastases. A case of clinically significant thyroid metastasis from primary MFH involving the thigh visualized on I-123 thyroid imaging is reported.     

肠系膜罕见原发肿瘤的CT表现(4例报告及文献复习)

目的: 描述肠系膜罕见原发肿瘤的CT 特点。材料与方法: 搜集4 例,其中恶性血管外皮细胞瘤( MHP) 和恶性纤维组织细胞瘤( MFH) 各1 例,神经纤维瘤( NF)2 例,均经手术和病理证实。与手术对照分析这些肿瘤的CT 表现特点。结果: MHP 原发肿瘤不具特征性,肝转移病灶可表现为多发的形态规则、界线清楚的圆形病灶,部分病灶内可见液面,可有双环征。MFH 仅表现为一不规则形软组织肿块。2 例NF 均表现为无痛性的、体积较大的且有明显的偏侧囊变的混合密度性肿块。结论: MHP 肝转移和NF 可能具有一定的CT 表现特征,但仍需获得组织学证实     

Differentiated thyroid cancer presenting with thyrotoxicosis due to functioning metastases

Thyrotoxicosis due to functioning metastases in differentiated thyroid cancer (DTC) is exceedingly rare. We report a case of follicular carcinoma in a 54-year-old manager, who presented with thyrotoxicosis, shortness of breath and lung metastases. Transbronchial biopsy of a pulmonary nodule demonstrated normal thyroid. This was interpreted as representing very well-differentiated thyroid cancer. CT, (131)I whole-body imaging and dosimetry is described following total thyroidectomy and repeated radioiodine administration (cumulative activity 34.6 GBq). The patient became asymptomatic with almost complete eradication of the pulmonary metastases. Potential complications of thyroid storm, bone marrow failure and pulmonary fibrosis following radioiodine are discussed, together with methods to minimise these risks.     

99mTc-Depreotide chest SPECT demonstrates pulmonary metastases from renal cell carcinoma

99mTc-Depreotide has been used on single pulmonary nodules to identify somatostatin receptor-positive lung cancer. We report that pulmonary metastases of a 78-y-old man with postradical nephrectomy for renal cell carcinoma were detected by (99m)Tc-depreotide chest SPECT. Thus, (99m)Tc-depreotide chest SPECT can be used to diagnose secondary lung cancer, such as pulmonary metastases from renal cell carcinoma with somatostatin receptor-positive tumor, other than primary lung cancer. Depending on whether the (99m)Tc-depreotide was positive for pulmonary metastases, the patient underwent an appropriate therapy without further invasive procedures.     

Seven cases of brain metastasis from papillary thyroid carcinoma

Brain metastases from differentiated thyroid carcinoma are extremely rare and carry a poor prognosis. We describe here clinical details of 7 cases of brain metastases from papillary thyroid carcinoma. Of 153 patients with metastases from differentiated thyroid carcinoma (papillary in 123, follicular in 30) treated at our institution between 1981 and 1999, 7 patients (4.6%) had brain metastases. Histologically, the primary tumor was papillary carcinoma in all 7 cases. Four were males and 3 were females. The median age at first diagnosis of distant metastases was 63 yr (range, 47-76 yr). Of these patients, one had brain metastases only and six had metastases to the lungs as well. Five of these patients were treated with 131I. Three of these 5 patients had marked uptake in the metastases (131I positive) on post-therapy 131I scans and another 2 patients had no significant activity (131I negative) in both pulmonary and brain metastatic lesions. One of 3 patients with 131I positive lesions had intense activity in the brain tumor, but no uptake in multiple pulmonary metastatic tumors. In a patient with 131I positive brain metastases, the tumors progressed rapidly after 131I therapy. In another one patient, acute hemorrhage of the tumor occurred four days after 131I therapy, requiring surgical removal. Loner case of 131I negative 2 patients was treated with radiosurgery (gamma-knife) and complete reduction in tumor volume was observed. On the other hand, one of 2 patients receiving no 131I therapy had radiosurgery (x-knife) and remaining one received conventional external radiation and chemotherapy for small solitary brain and pulmonary metastatic tumors. These therapeutic interventions were useful in both cases. The mean length of survival after the development of brain metastases in the five patients who died of the disease was 30 months. One patient treated with x-knife has been alive at 21 months and another one who has 131I uptake in the brain tumor without uptake in lung lesions has been alive 15 months after diagnosis of brain metastasis. These results indicate that it is important to detect brain metastasis by imaging techniques and Tg measurements and give treatment as early as possible since the brain is the third most common distant metastatic site and the prognosis is poor.     

Bone and gallium scan findings in malignant fibrous histiocytoma. Case report with radiographic and pathologic correlation

Malignant fibrous histiocytoma (MFH) is the most common soft tissue malignancy in adults. The Ga-67 citrate scan findings of an extremity-located MFH, the most common location of this neoplasm, have never been published in English language journals to the best of the authors' knowledge. Ga-67 citrate and Tc-99m MDP scans of the thigh mass accurately depicted the tumor's local extent, including the presence of central ischemic necrosis within the tumor, and the absence of adjacent osseous involvement and distant metastases, as correlated with computed tomography, angiography, and pathologic examinations.     

Results of whole lung irradiation and chemotherapy in comparison with partial lung irradiation in metastasizing, undifferentiated soft tissue sarcomas

The poor prognosis of patients with unresectable pulmonary metastases of soft tissue sarcoma is well known. In order to evaluate the beneficial effect of radiotherapy, we have treated 44 patients with pulmonary metastases of grade 3 soft tissue sarcoma from 1980 to 1986. In 36 patients the treatment volume was restricted to the single metastases up to a dose of 50 to 60 (9 to 10 Gy/week). The survival rate at one year was 18% and at two years 6%. Eight patients were treated with a combined regimen, consisting of cisplatin and ifosfamide with simultaneous whole lung irradiation. Irradiation was performed with 8 or 16 MV photons at a hyperfractionation of 2 x 0.8 Gy/day (8 Gy/week). After a dose of 12 Gy, the single metastases were boosted up to 50 to 60 Gy, with a second course of chemotherapy. In six of eight patients complete remissions were achieved, one patient showed a partial remission. The survival rate at 27 months was 50%. The patients with partial remission died from pulmonary progression at 23 months. One patient died after twelve months from a loco-regional recurrence in the tonsillar fossa without evidence of pulmonary disease. Side effects included alopecia and moderate bone marrow suppression approximately twelve days after each chemotherapy cycle. Pulmonary fibrosis was observed only at the high dose volume without impairment of respiratory function. From these observations the conclusion is drawn that whole lung irradiation simultaneously with cisplatin and ifosfamide chemotherapy provides good palliative results without relevant morbidity in patients with high grade unresectable pulmonary metastases of soft tissue sarcomas.