原发性大气道腺样囊性癌的CT表现  

CT fingdings of primary adenoid cystic carcinoma of the large airway

作　　者：莫森林 胡海菁 黄绥丹 倪志文 蒙虹伽 陈淮[2] MO Senlin;HU Haijing;HUANG Suidan;NI Zhiwen;MENG Hongjia;CHEN Huai(Department of Radiology,the Affiliated Nanhai Hospital of Southern Medical University,Foshan,Guangdong Province b2S200,China;Department of Radiology,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120,China)

机构地区：[1]南方医科大学附属南海医院放射科,广东佛山528200 [2]广州医科大学附属第一医院放射科,广东广州510120

出　　处：《实用放射学杂志》2021年第8期1250-1253,共4页Journal of Practical Radiology

基　　金：广东省普通高校特色创新类项目(2018KTSCX188);佛山市卫生健康局医学科研课题项目(20200381);佛山市“十三五”医学特色专科建设项目(FSTSZK011)。

摘　　要：目的探讨原发性大气道腺样囊性癌(ACC)的CT表现,提高对该病的诊断及鉴别诊断水平。方法回顾性收集经病理确诊为原发性大气道ACC的52例患者资料,分析并总结其CT征象。结果52例原发性大气道ACC均为单发、宽基底病灶,其中发生在气管30例、主支气管9例、中间段支气管1例、叶支气管2例、段支气管2例、呈浸润生长累及上述2个或以上位置者8例;肿瘤最大径1.9〜8.6 cm,平均(4.0±1.5)cm。9例表现为腔内型,31例表现为腔内外型,12例表现为管壁浸润增厚型,6例表现为大气道腔内病灶较小而腔外病灶较大;38例密度均匀,9例见钙化,41例表现为病灶长轴与大气道长轴平行。14例轻度强化,24例中度强化,10例明显强化;41例表现为静脉期强化程度高于动脉期呈渐进性强化。继发征象有:阻塞性肺气肿9例,阻塞性肺炎21例,阻塞性肺不张12例,阻塞以远支气管扩张并黏液栓潴留7例,纵隔移位7例,少量胸腔积液6例,肺门纵隔淋巴结肿大6例,肺部及肋骨转移1例。结论当发现中老年患者气管及主支气管的病灶沿管壁浸润增厚或腔内外生长,病灶长轴与气道长轴平行、增强扫描呈轻中度强化及渐进性强化时,应想到ACC可能。Objective To investigate the CT findings of primary adenoid cystic carcinoma(ACC)of the large airway and to improve the level of diagnosis and differential diagnosis of the disease.Methods The data of 52 patients with primary ACC of the large airway confirmed by pathology was analyzed retrospectively,and their CT finings were analyzed and summarizeiResults All the 52 lesions were single and broad-based,including 30 cases at trachea,9 cases at main bronchus,1 case at right middle bronchus,2 cases at lobar bronchus,2 cases at segmental bronchus,and 8 cases with invasive growth involving the above two or more positions.The maximum diameter of the tumors ranged from 1.9 cm to 8.6 cm,with the average of(4.0±1.5)cm.The intraluminal tumors were 9 cases,extra-and intra-luminal were 31 cases and infiltrative wall thickening were 12 cases,6 cases showed the extraluminal lesions were larger than the intraluminal parts.The density was homogeneous in 38 cases,and calcification was found in 9 cases.The length-diameter of the lesion was parallel to that of the large airway was found in 41 cases.Mild enhancement was found in 14 cases,moderate enhancement in 24 cases and obvious enhancement in 10 cases.The degree of enhancement in venous phase was higher than that in arterial phase was found in 41 cases.The secondary signs included 9 cases of obstructive emphysema,21 cases of obstructive pneumonia,12 cases of obstructive atelectasis,7 cases of distal bronchiectasis with mucous embolus retention,7 cases of mediastinal shift,6 cases of small pleural effusion,6 cases of hilar and mediastinal lymph node enlargement and 1 case of lung and rib metastasis.ConcIusion When lesion at trachea and main bronchus is found in middle-aged and elderly patients,showing infiltration and thickening along the tube wall or growth both extra-and intra-luminal,with the length-diameter of the lesion parallel to that of the airway,enhanced scan showing mild to moderate and gradual enhancement,then ACC should be considered.

关 键 词：大气道肿瘤 腺样囊性癌 计算机体层成像 

分 类 号：R734.1[医药卫生—肿瘤] R814.42[医药卫生—临床医学]