肺多形性癌的CT影像特征(附15例分析)  

CT features of pulmonary pleomorphic carcinoma

作　　者：陈晓东[1] 何滨[1] 罗泽斌[1] 

机构地区：[1]广东医学院附属医院放射科,广东湛江524001

出　　处：《影像诊断与介入放射学》2016年第3期204-209,共6页Diagnostic Imaging & Interventional Radiology

基　　金：2015广东医学院附属医院博士基金(BJ201521);广东医学院2009年青年基金(Q2009022)

摘　　要：目的探讨本院经手术病理证实的肺多形性癌病人CT影像特征。方法共15例经手术病理证实的病例进行回顾性分析,平均65.3±8.7岁,其中2例为胸部CT平扫,余13例为胸部CT平扫及增强扫描(动脉期及静脉期),分析内容主要包括肿瘤大小、位置、形态、密度、毛刺征、分叶征、肺门和纵隔淋巴结以及胸膜/胸壁等受到侵犯的情况。结果所有病例病理诊断均为肺多形性癌。显微镜下均见肉瘤样成分,包括梭形细胞和/或巨细胞,其中5例合并腺癌成分,1例合并鳞癌成分。免疫组化示CK和Vimentin均为阳性。CT平扫表现为较大肿物,平均最大径为4.5 cm,且多位于肺外周(13/15),14例具有分叶征,10例见毛刺征,7例瘤周有磨玻璃样阴影,10例侵犯邻近胸膜和/或胸壁,9例合并肺门和/或纵隔淋巴结转移,增强扫描10例有中央低强化区。结论肺多形性癌具有肺恶性肿瘤的特点,CT扫描对提高肺多形性癌的诊断有一定的帮助。Objective To determine the CT features of pulmonary pleomorphic carcinoma （PPC）. Methods Noncontrast （2） and dual-phase contrast-enhanced （13） CT of 15 patients （average age： 65.3±8.7 years） with histologically confirmed PPC was retrospectively analyzed. The tumor location, size, shape, density, margin, hilar and mediastinal lymph nodes, pleural and/or chest wall invasion were recorded. Results All tumors contained sarcomatoid components including spindle cells and/or giant cells combined with adenocarcinoma （5） and squamous carcinoma （1） components. Immunohistochemistry was positive for cytokeratin and vimentin in all cases. On CT,the tumors were large with the average maximum diameter of 4.5 cm, located in the lung periphery （13）. The tumor margin was lobulated （14） and/or spiculated （10） with peritumoral ground-glass opacity （7）, pleural and/or chest wall invasion （10）, hilar and/or mediastinal lymphadenopathy （9）. On enhanced CT, low-density areas were found in 10 tumors. Conclusion Malignant features may be helpful for the diagnosis of PPC on CT.

关 键 词：肺 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] R730.44[医药卫生—临床医学]