呼吸系统 | 孤立性纤维性肿瘤 | solitary fibrous tumor
51/M,Dyspnea for 1 month.
51岁男性，呼吸困难1月余。
图1 胸片正位
图2 胸部CT增强纵隔窗
图3 胸部CT增强纵隔窗
图4 胸部CT增强纵隔窗 冠状面
图5 PET-CT
Chest radiograph shows large mass occupying left hemithorax and multiple masses in right lung.
胸片显示左侧胸腔巨大肿块，右肺多发肿块。
Chest CT shows a huge heterogeneous enhancing mass with intratumoral vessels in left hemithorax. The mass was arising from left pleura and extending to mediastinum. There are multiple masses in right lung. Pericardial effusion was also seen.
胸部CT显示左侧胸腔巨大不均匀强化肿块，肿瘤内见血管。肿块起源于左侧胸膜并延伸至纵隔。右肺多发肿块。心包积液。
The lesions show increased FDG uptake.
病变FDG摄取增加。
Malignant solitary fibrous tumor
恶性孤立性纤维性肿瘤
The patient underwent CT-guided percutaneous biopsy for the mass. Mitotic activity was 5/10HPF.
行CT引导下经皮穿刺活检。有丝分裂活性为5/10HPF。
Solitary fibrous tumors of the pleura (SFTP), are a rare benign pleural-based tumor that accounts for <5% of all tumors involving the pleura.
孤立性纤维性肿瘤（SFTP）是一种罕见的良性胸膜肿瘤，占所有胸膜肿瘤的5%以下。
It usually presents in the 6th to 7th decades and has no significant sex predilection.
该病通常发生于在60至70岁，无明显性别倾向。
Although approximately half of SFTP patients are asymptomatic, cough, chest pain, and dyspnea may be presented, especially in patients with relatively large tumors.
约一半SFTP患者无症状，但咳嗽、胸痛和呼吸困难可能出现，尤其在相对大的肿瘤患者中。
There may be a predilection towards the mid to lower zones of the chest. In ~80% of cases, they arise from visceral pleura, with the remainder arising from the parietal pleura.
肿瘤倾向发生于胸部中下部。80%的病例来自脏层胸膜，其余的病例来自壁层胸膜。
On CT scan, it tends to have soft tissue attenuation on unenhanced scans and show relatively homogenous intense background enhancement on contrast enhanced scans (from rich vascularization). Non-enhancing areas may be present corresponding to necrosis, myxoid degeneration, or hemorrhage within the tumor.
CT表现为：平扫呈软组织肿块。增强后相对均匀强化（富血供）。非强化区可能与肿瘤内坏死、粘液样变性或出血相对应。
About 20% of SFTs are malignant.
大约20%的SFT是恶性的。
Proposed criteria for malignancy include increased cellularity, mitotic activity (>4/10hpf), and necrosis (coagulative necrosis associated with tumor cells).
恶性肿瘤标准包括细胞数量增加、有丝分裂活性（>4/10hpf）和坏死（与肿瘤细胞相关的凝固性坏死）。
Malignant form is hardly distinguishable from benign forms, but tends to be larger than 10 cm and more likely to be associated with internal low attenuation and pleural metastasis.
恶性形态很难与良性形态区分，但往往大于10cm，更可能与内部低密度及胸膜转移有关。
visceral[ˈvisərəl] pleura 脏层胸膜
parietal[pəˈraiətəl] pleura 壁层胸膜
rich vascularization:富血供
mitotic[mɪ'tɒtɪk] adj.有丝分裂的