原发性肺胶样腺癌的CT表现及病理学基础分析  

CT and Pathological Features of Primary Lung Colloid Adenocarcinoma

作　　者：王迪[1] 于红[1] 夏春燕[2] 肖湘生[1] 李惠民[3] 刘士远[1] 叶晓丹[4] 

机构地区：[1]第二军医大学附属长征医院影像科,上海200003 [2]第二军医大学附属长征医院病理科,上海200003 [3]上海交通大学附属新华医院影像科,200092 [4]上海交通大学附属胸科医院影像科,200025

出　　处：《临床放射学杂志》2013年第10期1440-1444,共5页Journal of Clinical Radiology

摘　　要：目的探讨原发性肺胶样腺癌的cT表现及相关病理学基础，以提高对其认识水平。方法13例经病理证实的原发性肺胶样腺癌纳入研究，其中男7例，女6例，年龄平均56岁（36—74岁）。13例均行CT平扫，11例行增强扫描，9例进行免疫组织化学分析，分析蛋白指标为CK7、CK20和TTF-1。结果11例单发，其中周围型8例；9例病灶为类圆形结节／肿块影，3例形态不规则，1例为实变影。病灶边界均清楚。11例见分叶征。CT平扫囊实性密度7例，实性密度4例，混杂磨玻璃密度2例。增强扫描7例囊实性病灶实性成分无强化1例，轻度强化4例，轻至中度不均匀强化2例；4例实性密度病灶无强化2例，轻至中度不均匀强化2例；3例病灶周围见磨玻璃密度影。镜下见“黏液湖”形成，并见少量肿瘤细胞“漂浮”在湖中；免疫组织化学指标CK7、CK20和TTF-1阳性率分别为77．8％（7／9）、55．6％（5／9）和77．8％（7／9）。结论原发性肺胶样腺癌CT表现多样，典型者表现为周围型结节或肿块，病灶内多可见囊性成分，增强扫描轻度强化或无强化为主。分叶多见但无毛刺、棘状突起。结合CK7、CK20、TTF-1阳性有助于提示胶样腺癌。Objective To investigate the CT and pathological features of primary pulmonary colloid adenocarcinoma in order to improve the diagnosis. Methods CT images of 13 patients （7 males and 6 females, mean age of 56 years, range from 36 to 74years. ） with pulmonary colloid adenocareinoma histopathologically confirmed were retrospectively analyzed. 11 patients performed comtrast CT scan. 8 patients performed immunohistoehemical study, the analysis indicators include CK7, CK20 and TTF 1. Results 11 of 13 patients were single lesions, 2 patient showed metastatic tumors in both lungs on CT. The CT images showed round nodules or masses in 9 lesions , irregular masses in 3 lesions, lobulated shape in 11 lesions, consolidation in 1 lesion. On plain CT images, 7 lesions showed cystic-solid opacities, 4 lesions showed solid o- pacities, 2 lesions showed mixed ground glass opacities. On contrast CT images, the lesions showed no enhancement in 3, mild enhancement in 4, mild to moderate inhomogeneous enhancement in 4. 3 tumors had ground-glass opacities around the lesions and showed poorly defined. The positive rate of the expression of CK7, CK20 and TTF-1 were 77.8% （7/9） , 55.6% （5/9） ,77.8% （7/9）respectively. Conclusion Primary pulmonary colloid adenoearcinoma has specific charac- teristic on CT and may be helpful for diagnosis before operation. Besides, the lesions showed high expression of CK7, CK20 and TTF 1. The final diagnosis depends on pathology.

关 键 词：胶样腺癌 肺癌 体层摄影术 X线计算机 

分 类 号：R734.2[医药卫生—肿瘤]