胸腺神经内分泌肿瘤的CT表现、病理及临床特征  

CT Findings, Pathology and Clinical Features of Thymic Neuroendocrine Tumors

作　　者：段江晖[1] 胡莹莹[1] 孙宏亮[1] 谢晟[1] 谭煌英[2] 刘平平[3] 刘良楹 DUAN Jianghui;HU Yingying;SUN Hongliang;XIE Sheng;TAN Huangying;LIU Pingping;LIU Liangying(Department of Radiology,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院放射诊断科,北京100029 [2]中日友好医院中西医结合肿瘤内科,北京100029 [3]中日友好医院病理科,北京100029 [4]中国人民解放军总医院医学信息室,北京100853

出　　处：《中国医学影像学杂志》2019年第5期351-354,359,共5页Chinese Journal of Medical Imaging

摘　　要：目的探讨胸腺神经内分泌肿瘤(TNETs)的CT表现、病理及临床特点,提高对本病的认识。资料与方法回顾性分析13例病理证实的TNETs患者,总结其临床及病理特点,并参照国际胸腺肿瘤协作组织标准术语及第8版美国癌症联合会和国际抗癌联盟胸腺上皮肿瘤TNM分期系统,分析13例患者的CT资料,并进行分期。结果病变主体均位于前纵隔,轴位最大径4.3~14.1cm,中位最大径8.9cm。病灶呈分叶状11例、类圆形2例,囊变坏死10例,钙化2例。11例行增强扫描,其中中-高度强化9例、轻度强化2例,8例有瘤内血管。纵隔结构受累12例,肿瘤侵犯邻近肺组织6例。胸内转移7例,胸外转移6例。临床分期:Ⅰ期1例,ⅢA期4例,ⅣB期8例。组织病理亚型:不典型类癌11例,大细胞神经内分泌癌1例,小细胞癌1例。4例术后患者获得随访,其中1例复发和转移,1例转移。结论TNETs的CT表现为前纵隔体积较大的分叶状肿块,坏死囊变常见,钙化少见,增强扫描呈中-高度强化,肿瘤易侵犯周围结构,转移较常见。TNETs的病理及临床特点均有一定的特征性。Purpose To discuss the CT findings, pathology and clinical features of thymic neuroendocrine tumors (TNETs), and to improve the understanding of this disease. Materials and Methods A retrospective analysis was performed on 13 TNETs patients confirmed by pathology, and their clinical and pathological features were summarized. According to the International Thymic Malignancies Interest Group standard terminology, the eighth edition of the American Joint Committee on Cancer and the Union for International Cancer Control TNM staging system for thymic epithelial tumor, the CT imaging data of 13 patients were analyzed and staged. Results The lesions were mainly located in the anterior mediastinum, and the median maximum diameters of lesions were 8.9 cm (range: 4.3-14.1 cm) in the axial images. 11 lesions was lobulated and 2 lesions was round-alike;10 cases contained cystic degeneration and 2 cases contained calcification. Among 11 cases of enhanced CT scan, 9 cases showed moderate to significant enhancement, 2 cases presented mild enhancement, and 8 cases showed intratumoral blood vessels. There were 12 cases of mediastinal structure involvement and 6 cases of pulmonary invasion, and there were 7 patients with intrathoracic metastasis and 6 cases with extrapleural metastasis. The patients demonstrated stage Ⅰ(n=1), stage ⅢA (n=4) and stage ⅣB (n=8). The histopathological subtypes included 11 cases of atypical carcinoid, 1 case of large cell neuroendocrine carcinoma and 1 case of small cell carcinoma. Four cases were followed up after surgery, in which, 1 case showed recurrence and metastases, and 1 case suffered metastases. Conclusion The CT findings of TNETs are lobulated masses with large anterior mediastinal volume, and the necrotic cystic changes are common but the calcification is rare. Moreover, there is moderate to significant enhancement in post-contrast scan, and the tumor tends to invade the surrounding structures and the metastasis is common. Therefore both pathology and clinic manifestations of TNETs

关 键 词：胸腺肿瘤 癌 神经内分泌 体层摄影术 X线计算机 病理学 外科 

分 类 号：R445.3[医药卫生—影像医学与核医学] R736.3[医药卫生—诊断学]