腹部原发性恶性纤维组织细胞瘤的CT表现

目的：探讨腹部原发性恶性纤维组织细胞瘤(MFH)的 CT 表现。方法回顾性分析经手术病理证实的17例腹部原发性 MFH 的 CT 表现及临床病理资料。结果腹膜后6例，肝脏5例，肾脏2例，肠系膜1例，大网膜1例，胃1例，回肠1例。肿块呈椭圆形、分叶状、结节形，体积较大。除2例胃肠道 MFH 呈均匀稍低密度影外，余病灶为稍低密度影内夹杂更低密度坏死区。增强后，腹膜后、大网膜、肠系膜及肝脏 MFH 多表现为实性成分、内部分隔呈渐进性或持续性强化，坏死部分无强化；肾脏病例边界不清，呈轻度持续性强化，程度低于正常肾实质；胃及回肠病变呈均匀持续性强化，对应胃肠黏膜正常。结论腹膜后 MHF 影像表现具有间质性肿瘤的特点，绝大部分病灶呈现渐进性及持续性强化的特征，与相应部位的癌肿影像表现明显不同。

CT appearances of abdominal primary malignant fibrous histiocytoma

Objective To investigate CT appearances of abdominal primary malignant fibrous histiocytoma(MFH).Methods The CT characteristics,clinical features and pathological data of 1 7 patients with MFH proved pathologically were analyzed retrospectively. Results The lesions located in retroperitoneum were 6,in liver were 5,in kidney were 2,in superior mesentery was 1,in greater omentum was 1,in stomach was 1,in ileum was 1.The lesions are oval shape,lobulated,nodule shape,and the size of these lesions were large. 2 cases of MFH located in gastrointestinal tract were slightly low density,and the remaining were uneven high density due to necro-sis.In CT contrast enhanced scan,the solid portion and internal divisions showed progressive or continuous enhancement,and the nec-rosis were not enhanced in MFH located in the retroperitoneum,the greater omentum,the superior mesentery and the liver.MFH in kidney was poorly circumscribed and showed mild progressive enhancement lower than normal renal parenchyma.The stomach and ileum lesions showed uniform and continuous enhancement with normal gastrointestinal mucosa in corresponding parts.Conclusion Imaging features of retroperitoneal MFH were the same as those of interstitial tumors,and most tumors showed features of progres-sive and persistent enhancement,but have different imaging appearances with the malignant lesions in corresponding parts.