原发性肺淋巴上皮瘤样癌的影像表现及病理特征  

Imaging and pathological features of primary pulmonary lymphoepithelioma-like carcinoma

作　　者：全勇[1] 唐秉航[1] 李良才[1] 黄德成[1] QUAN Yong;TANG Bing-hang;LI Liang-cai(Zhongshan City People＇s Hospital,Guangdong 528403,Chin)

机构地区：[1]中山市人民医院CT室,广东528403

出　　处：《放射学实践》2018年第6期565-568,共4页Radiologic Practice

摘　　要：目的:探讨原发性肺淋巴上皮瘤样癌(LELC)的影像表现及病理特征。方法:回顾性分析2006年1月至2017年7月18例经手术病理证实的肺LELC的影像及病理资料。其中男6例,女12例;年龄26~73岁,中位年龄52岁,均接受CT检查。结果:18例患者共检出19个瘤灶,右肺13例共14个瘤灶(1例右下肺有2个瘤灶),左肺4例4个瘤灶;18个瘤灶均位于双肺中下叶,单发为主,1例肺部未见瘤灶,仅见纵隔淋巴结肿大并融合。平扫病灶无论大小,均呈密度较均匀的实性结节或肿块,边界多清晰,部分可见分叶和毛刺征,无钙化和空洞;增强扫描病变处血管包埋或推移,静脉期呈实性不均匀强化,实质内可见斑片状、小片状低密度区,位于病灶中心、边缘或间杂分布。病理示该肿瘤为多形性上皮源性,肿瘤细胞呈片状、多角形,体积较大,界限欠清,周围间质伴较多淋巴细胞和浆细胞浸润;免疫组织化学染色EBER、CK、CK5/6、P63(+)支持诊断。结论:原发性肺LELC影像表现有一定特征性,病理免疫组化可以明确诊断。Objective：To investigate the imaging findings and pathological features of primary pulmonary lymphoepithelioma-like carcinoma（LELC）.Methods：The imaging and pathologic data of18 cases with lung LELC confirmed by operation and pathology from November 2006 to July 2017 were retrospectively analyzed,including 6 males and 12 females,aged from 26 to 73 years,mean age 52 years.All patients underwent CT examination.Results：A total of 19 tumors were detected in 18 patients（one patient had 2 tumors）,including 13 tumors in the right lung,and 4 tuomrs in the left lung;18 tumors were located in the middle and lower lobe of the lung.In one case,the tumor was not seen in the lung,only the enlargement and fusion of the mediastinal lymph nodes could be seen.All tumors showed homogeneous density on non-enhanced CT,with clear boundary,lobulation and spiculation was seen in some of the cases,there was no calcification and cavity;On enhanced CT imaging,the vessels were embedded or displaced.In venous phase,heterogeneous enhancement was shown.In parenchyma there was patchy areas of low density locating at center or periphery or uneven distributed.Pathology showed that the tumor was originated from polymorphic epithelium,the tumor cells were flaky、polygonal,large and with less clear boundaries,in the surrounding interstitium there were much lymphocytes and plasma cell infiltration;immunohistochemistry EBER、CK、CK5/6、P63（＋）supported the diagnosis.Conclusion：The image performance of primary lung LELC was characteristic,and pathological immunohistochemistry examination could confirm the diagnosis.

关 键 词：肺肿瘤 淋巴瘤 体层摄影术 X线计算机 

分 类 号：R734.2[医药卫生—肿瘤]