肺部原发多形性癌MSCT表现  

Manifestations of multi-slice spiral CT of primary pulmonary pleomorphic carcinoma

作　　者：江凯[1] 邓生德[1] 蔡志强[2] 王玉涛[1] 徐裕[1] 

机构地区：[1]宁波大学医学院附属医院放射科,浙江宁波315020 [2]浙江省宁波市第一医院放射科,浙江宁波315010

出　　处：《医学影像学杂志》2015年第11期1949-1952,共4页Journal of Medical Imaging

基　　金：宁波大学校级科研项目(编号:XYY11060)

摘　　要：目的探讨肺部原发多形性癌MSCT表现。方法回顾性分析6例经病理证实的肺部原发多形性癌的MSCT表现,并复习文献。结果 6例均位于右肺上叶;1例因肿块巨大未分型,其余5例均为周围型;5例见假包膜,肺门、纵隔淋巴结转移2例,空洞1例,1例伴广泛小叶间隔增厚及磨玻璃密度影;均行平扫及增强CT检查,其中6例呈进行性强化,强化不均,肿块呈厚薄不均的环形强化,5例可见"浮冰样"改变。结论肺部原发多形性癌以上叶胸膜下区常见;肿块常较大,边缘常光整,可伴假包膜、坏死、空洞;增强扫描呈进行性不均匀强化,边缘呈厚薄不均的环形强化,有"浮冰样"表现,对多形性癌有一定诊断价值。Objective To explore the MSCT manifestations of primary lung pleomorphic carcinoma.Methods We retrospectively analyzed MSCT manifestations of six cases of primary lung pleomorphic carcinoma confirmed by pathology and reviewed the relevant the literature in this work.Results All of those six cases were located in the right upper lobe,of which one case was impossible to distinguish the type because of the huge mass and the remaining five cases were peripheral type.Of those six cases,five cases presented with pseudocapsule,two cases with metastases of hilar lymph and mediastinum nodes,one case with cavity,and one case with extensive lung alveolar septal thickening and ground glass shadow.All of those six cases underwent the enhanced CT.Six cases appeared the uneven enhancement.The masses exhibited uneven thickness of the annular enhancement and five cases presented with ＂ floating-ice＂ changes.Conclusion Primary pulmonary pleomorphic carcinoma is commonly originated from the subpleural areas of upper lobe of the lung.The mass is often larger and the edge often smooth,which may be accompanied with pseudocapsule,degeneration,necrosis,and cavity within the tumor.The enhanced scan appears progressive uneven enhancement,with uneven thickness of annular enhancement and ＂ice-like＂ alteration,which has some diagnostic value for sarcomatoid carcinoma.

关 键 词：肺 原发多形性癌 体层摄影术 X线计算机 

分 类 号：R734.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]