胸腺上皮肿瘤CT表现与WHO病理分型的相关性研究  

Relationship Between CT Manifestations of Thymic Epithelial Tumors and the WHO Pathological Classification

作　　者：屈艳娟[1] 陈鑫[2] 廖美焱[1] 胡慧娟[1] 周素军[1] 杨桂芳[3] 

机构地区：[1]武汉大学中南医院放射科,湖北武汉430071 [2]武汉亚洲心脏病医院放射科,湖北武汉430022 [3]武汉大学中南医院病理科,湖北武汉430071

出　　处：《武汉大学学报（医学版）》2013年第2期229-233,共5页Medical Journal of Wuhan University

基　　金：湖北省自然科学基金资助项目(编号:2012FFB04422)

摘　　要：目的:探讨胸腺上皮肿瘤CT表现与WHO病理分型之间的关系。方法:对105例胸腺上皮肿瘤采用2004年WHO分类法进行病理分型。利用CT资料统计肿瘤大小、形状、钙化、坏死或囊变、包膜完整性、邻近组织侵犯、淋巴结肿大及有无胸水,对不同病理类型胸腺瘤的CT表现进行χ2检验或精确概率法检验,分析其CT表现间的差异性,以P<0.05为差异具有显著性。结果:105例中男性52例,女性53例;年龄18-75岁,平均(47.98±12.54)岁。不同病理类型胸腺肿瘤中大小、形状、坏死或囊变、包膜完整性、邻近组织侵犯、淋巴结肿大及有无胸水差异有显著性(P<0.05)。B2型、B3型及胸腺癌较其它型瘤体大,B3型胸腺瘤及胸腺癌超过50%瘤体大于10cm。A、AB及B1型多为圆形或类圆形,B3型胸腺瘤75%及胸腺癌85%瘤体不规则。B3型胸腺瘤及胸腺癌出现坏死或囊变分别为67%、57%。B3型胸腺瘤83%、胸腺癌100%包膜破坏。随着恶性程度增高瘤周组织侵犯率升高,B2型为33%、B3型为75%、胸腺癌为81%。B3型50%、胸腺癌48%出现胸水。钙化多见于B型胸腺瘤。结论:不同病理类型胸腺上皮肿瘤有不同的CT表现,CT表现能反映胸腺肿瘤病理特点。Objective： To explore the relationship between CT manifestations of thymoma and its WHO pathological classification. Methods： One hundred and five histopathologically confirmed cases were collected for their pathological and CT characteristics. CT manifestations between different pathological types of thymoma were statistically compared. Results： Tumor size, shape, necrosis or cystic change, capsule integrity, invasion to the adjacent tissue, lymphadenopathy, and the presence of pleural effusion were significantly different among different pathological types of thy- momas （P〈0.05）. Type B2, B3 tumors and thymic carcinoma were greater in size than other types. More than 50% of type B3 tumors and thymic carcinomas had a tumor size greater than 10cm. The shape of types A, AB, and B1 tumors were mostly round or oval, whereas 75% of type B3 tumors and 85 % of thymic carcinomas were irregular in shape. Necrosis or cystic change oc- curred in 67% of type B3 thymomas and 57% of thymic carcinomas, respectively. Capsule de- struction occurred in 83% of type B3 thymomas and 100% of thymic carcinomas. Increases in the degree of malignancy were associated with increases in the incidence of surrounding tissue invasion as the incidence was 33 %, 75 %, and 81% respectively in type 132, type B3, and thymic carcinomas. Pleural effusion occurred in 48% of thymic carcinomas, while calcification was observed mostly in type B thy- momas. Conclusion. Different pathological types of thymic epithelial tumors have different CT manifesta- tions. Distinctive CT features of thymomas may reflect their pathological types.

关 键 词：CT 胸腺 胸腺上皮肿瘤 胸腺癌 病理 

分 类 号：R445.3[医药卫生—影像医学与核医学] R736.3[医药卫生—诊断学]