原发性肺粘液表皮样癌的多排螺旋CT表现与病理对照研究  

Primary Pulmonary Mucoepidermoid Carcinoma: Correlation between Multi-Detecter Spiral CT Manifestations and Histopathological Findings

作　　者：陈辉[1] 余建群[1] 徐忠孜[1] 曾涵江[1] 罗艺[1] 陈冬冬[1] 

机构地区：[1]四川大学华西医院放射科,成都610041

出　　处：《临床放射学杂志》2014年第5期702-706,共5页Journal of Clinical Radiology

摘　　要：目的探讨原发性肺粘液表皮样癌（MEC）的多排螺旋CT（MDCT）表现及病理学特点。方法回顾分析华西医院2008年1月至2013年5月术前行MDCT检查，手术病理证实为MEC51例患者，结合组织病理所见观察及评价其MDCT表现。结果51例患者MDCT表现：（1）部位：中央型44例，周围型7例；气管颈段4例，主支气管7例，叶支气管2l例，段支气管12例，肺段以下支气管7例。（2）大小及形态：病灶直径10～83mm，平均（38±6．5）mm。31例病灶的最长径与支气管长径平行，25例病灶与近心端支气管管腔呈钝角；（3）密度、强化及内部结构特征：平扫病灶呈欠均匀低～中等密度。灶内点状钙化28例，空洞4例，坏死3例。明显不均匀强化13例，CT增强值为41—77HU，平均（54±3．1）HU；轻中度不均匀强化38例，CT增强值6～36HU，平均（22．6±2．4）HU；（4）病灶周围：25例灶周见“空气新月征”。结论MEC多为中央型，多位于叶或段支气管腔内。瘤内钙化较其他肺癌多见。病灶大多欠均匀低～中等密度，增强可轻中度或明显不均匀强化。病灶最长径与支气管长径平行，灶周伴“空气新月征”及气道阻塞表现。Objective To investigate the multi-detecter CT （MDCT） manifestations of primary pulmonary mucoepidermoid carcinoma, and to correlate CT features with histopathological findings. Methods During the period from January 2008 and May 2013 at West China Hospital, preoperative MDCT was carried out in patients with suspected lung diseases. Among them, 51 cases were pathologically confirmed to have primary pulmonary mucoepidermoid carcinoma. The CT manifestations were analyzed and were also correlated with histopathological features. Results MDCT manifestations of primary pulmonary mucoepidermoid carcinoma in the 51 patients were as follows. （ 1 ） Lesion location ： central type （ n = 44 ） and peripheral type （ n = 7 ）. The tumors were located in the trachea （ n = 4 ） , main bronchus （ n = 7 ） , lobar bronchus （ n =21 ） , segmental bronchus （ n = 12） or below segmental bronchus （ n = 7）. （2） Lesion size and shape ： diameter （ 10 - 83） mm with a mean of （38 ± 6.5 ） mm. （3） Density, enhancement and inner structure. On t3lain CT scans the lesions were oflow-middle density with intratumoral punctate calcifications （ n = 28 ） , cavity （ n = 4） or necrosis （ n = 3 ）. On contrast-enhanced CT scans, the lesions showed marked heterogeneous enhancement （ n = 13, 41 - 77 HU） or mild-moderate en- hancement （n = 38, 6 -36 HU）. （4） Additional finding was ＂crescent air sign＂, which was located at the peripheral region of the tumor （ n = 25 ）. Conclusion Primary pulmonary mucoepidermoid carcinoma is usually located within a lobar and segmental bronchus, which is characterized by a smoothly-margined airway mass on MDCT scans. The tumor＇s longest diameter is parallel to the bronchial branching direction. The incidence of calcification in mucoepidermoid carcinoma is much higher than that in other pulmonary carcinomas. On the contrast-enhanced CT scans, the lesions usually display marked or mild-moderate heterogeneous enhancement. Coexisting signs of a

关 键 词：肺粘液表皮样 癌体层摄影术 X线计算机 病理 

分 类 号：R734.2[医药卫生—肿瘤]