原发性肺肉瘤的影像诊断  

Chest radiograph and CT diagnosis of primary pulmonary sarcoma

作　　者：王成林[1] 张玉昆[1] 王立振[1] 陆普选[1] 吴政光[1] 龚小龙[1] 

机构地区：[1]北京大学深圳医院,广东深圳518036

出　　处：《中国基层医药》2004年第9期1053-1054,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的　探讨原发性肺肉瘤的胸部平片及CT表现 ,提高诊断的准确性。方法　回顾分析 14例经手术和病理证实资料完整的原发性肺肉瘤临床和影像学资料。结果　 14例原发性肺肉瘤的主要临床表现包括咳嗽 11例 ,胸痛 9例 ,咯血 9例 ,胸闷 6例 ;胸部平片 14例均为单发病灶 ,病灶直径大小 4～ 12 3cm ,密度均匀 ,未见淋巴结肿大 ,11例呈圆形或椭圆形 ,10例病灶边缘光滑清楚 ,4例可见分叶征 ,无毛刺征 ;9例做CT检查 ,病灶直径大小 4 9～ 12 8cm ,其中 5例密度均匀 ,4例密度欠匀 ,可见中心坏死或钙化灶 ,3例为圆形 ,6例为不规则形 ,9例边缘光滑 ,3例边缘模糊 ,伴局部侵犯 ,5例可见明显分叶征 ,注入对比剂后 6例病灶明显强化。结论　原发性肺肉瘤临床表现无特异性 ,胸片或CT表现肿块轮廓清楚 ,边缘光滑 ,直径多在 4cm以上 ,可有中心坏死、钙化及局部侵犯 ,增强CT有明显强化 。Objective To investigate the X-ray and CT findings of primary pulmonary sarcomas so as to promote the diagnostic accuracy.Methods A total of 14 patients,with complete data,were confirmed by pathology and surgery.The imaging findings of primary pulmonary sarcomas were analyzed retrospectively.Results The main symptoms were cough(11),chest pain(9),hemoptysis(9) and breathless(6);under chest radiographs all the 14 cases had single focus lesion with presenting 4～12.3cm in diameter,homogenous,and but without enlargement of local lymph node.11 of lesions were circular or elliptic;10 had well-defined and smooth edge;4 had lobulated sign;no cases had spicule sign.By CT scanning 9 patients had lesions of 4.9～12.8cm in diameter;5 of them were hemogenous;4 were not hemogenous with central necrosis or calcification;3 were circular;6 were irregular;9 cases had smooth edge;3 had dim edge with local invasion.After injected with contrast agent,6 cases showed marked postcontrast enhancement.Conclusion Clinical manifestations of primary pulmonary sarcomas were not specific;X-ray and CT findings had well-defined and smooth edge,and most of them had a size of more than 4cm,some had inraded invade local site and enlargement of lymph node of the hilum and mediastinum at later stage.

关 键 词：原发性 病灶 肉瘤 胸部平片 分叶征 坏死 影像诊断 

分 类 号：R734.2[医药卫生—肿瘤] R737[医药卫生—临床医学]