The Radiologic Manifestations of Malignant Fibrous Histiocytoma

惡性纖維組織細胞瘤之放射綫表現

高常發(S.F. Ko) ； 吳冠群(K.K. Ng) ； 吳樹鏗(S.H. Ng) ； 白錫卿(S.C. Pai) ； 蔡春泉(C.C. Tsai)

《中華放射線醫學雜誌》 14卷4期 (1989/12) Pp. 331-340

摘要

從1984年到1988年，共收集26個已由病理證實為惡性纖維組織細胞瘤(MFH)的病例。病人年齡由28歲至71歲（平均51.7歲）。男女比例為15:11。分佈包括：四肢（15例）；後腹腔（3例），頭頸（3例）、骨（2例），腸系膜，舌頭及肺（各1例）。放射綫檢查包括：一般性檢查（26例），電腦斷層（11例）,核子醫學（9例）及血管攝影（5例）。四肢軟組織 MFH為不具特異性之腫塊。後腹膜及頭頸部之MFH為巨大，有侵襲性之腫瘤，且常侵犯鄰近器官。肺原性MFH表現為一邊綠清晰，有離心性鈣化之大腫塊。腸系膜MFH卻只有在鋇灌腸中表現出對迴腸有外在壓迫。原發性骨MFH為邊綠不清，擴張性，骨溶性之病灶。由於MFH可發生於任何部位而放射續表現多變，手術前準確之診斷十分困難。但在老年人之軟組織腫瘤，MFH的鑑別診斷是不可忽略的。除此外，放射綫檢查可精確描繪出此腫瘤之範圍，對此腫瘤之治療，樹從是很有助益及重要的。

並列摘要

From 1984 to 1988, 26 patients with pathologically proven malignant fibrous histiocytoma (MFH) were collected and their radiologic findings were reviewed. The age of our patients ranged from 28 to 71 years (average 51.7 years).The sex ratio was M:F15:11. Diverse anatomic distribution included: extremities (15 cases); retroperitoneum (3 cases); head and neck (3 cases); bone (2 cases); mesentery, tongue and lung (1 case each). Radiologic studies included conventional radiography in all cases, computed tomography (CT) in 11 cases, nuclear medicine in 9 cases and angiography in 5 cases. MFH arised from the soft tissue of the extremities appeared as non-specific soft tissue masses. MFH of the retroperitoneum, head and neck were large, invasive tumors with destruction of adjacent structures. A large, well-defined mass density with eccentric amorphous calcifications was seen in the pulmonary MFH. In the mesenteric MFH, only mass effect on terminal ileum was shown in barium enema. Primary MFH of the bone presented as ill-defined lytic lesion. We believe that most of the MFH cannot be diagnosed pre-operatively. However, it should be considered in the differential diagnosis of the soft tissue tumor in aged patients. Besides, detailed radiologic investigations provide accurate delineation of tumor extent so that optimal management could be instituted.

並列關鍵字

malignant fibrous histiocytoma