摘要目的 报道1例胸膜腔内骨外骨肉瘤病.方法 2009年3月解放军第三○九医院收治的胸膜腔骨外骨肉瘤1例,并结合文献报道的6例胸膜腔内骨外骨肉瘤病例的临床特点、影像学和病理组织学资料进行分析.结果 患者男,47岁,因胸闷、气短1月余入院.左侧胸腔后下部有一巨大软组织肿块影,自左后肋膈角区向上延升至左肺门后方,形态不规则,体积约为10.9 cm×9.2 cm×17.7 cm,密度不均匀,有坏死囊变区和多发钙化灶,钙化灶成团聚集在肿块中央区,以肿块下部为著.手术切除肿瘤组织,镜下可见肿瘤性骨样组织,诊断为骨外骨肉瘤.结论 胸膜腔内骨外骨肉瘤是罕见的软组织高度恶性肿瘤,起病隐袭.主要表现为胸腔内巨大软组织影伴广泛钙化灶,钙化灶呈棉絮状或光芒状的高密度影.本病须与发生在胸腔和纵隔的胸膜结核、恶性问皮瘤伴钙化和胸骨骨肉瘤等其他疾病相鉴别.

abstractsObjective To describe the manifestations and diagnosis of pleural cavity extraskeletal osteosarcoma (ESO). Methods One case of ESO diagnosed at the Research Institute of Tuberculosis, 309th Hospital of PLA was reported. Six eases reported in the literature were reviewed. Results Chest CT of a middle-aged man revealed an enormous heterogeneous neoplasm, about 10. 9 cm ×9. 2 cm× 17.7 cm in size, in the left pleural cavity. There was abundant calcification in the tumor, with signs of invasion into the diaphragm and the pleura. Pleural effusion of the left thoracic cavity was also seen on the chest CT.Osteosarcoma was confirmed by pathological study after surgical resection of the tumor. Conclusions ESO is a rare malignant soft tissue sarcoma. Pleural cavity ESO is insidious and imaging studies often reveal a huge mass with abundant calcification. The differential diagnosis includes benign and malignant diseases of the thorax.