含囊腔周围型肺癌的CT表现  

CT features of peripheral lung cancer with cystic cavity

作　　者：卢俊[1] 尹化斌 刘磊[1] 杨新国[1] 庞闽厦[1] 汤海涛[3] LU Jun;YIN Huabin;LIU Lei;YANG Xinguo;PANG Minxia;TANG Haitao(Department of CT Examination,Shengli Oilfield Central Hospital,Dongying,Shandong Province 257034,China;Department of Radiology,the Fifth People's Hospital of Shanghai,Fudan University,Shanghai 200240,China;Department of Surgery,Shengli Oilfield Central Hospital,Dongying,Shandong Province 257034,China)

机构地区：[1]胜利油田中心医院CT检查科,山东东营257034 [2]复旦大学附属上海市第五人民医院放射科,上海200240 [3]胜利油田中心医院普外科,山东东营257034

出　　处：《实用放射学杂志》2021年第10期1618-1621,共4页Journal of Practical Radiology

摘　　要：目的探讨含囊腔周围型肺癌的CT表现特点.方法回顾性分析32例经病理证实的含囊腔周围型肺癌患者的临床影像和病理资料.结果32例患者中,浸润性腺癌28例(高G中分化12例、中分化10例、中G低分化6例)、原位腺癌2例,鳞癌2例.周围型肺癌CT征象:形态不规则26例,分叶征30例、毛刺征15例,支气管充气征4例、支气管截断征4例,血管集束征11例、胸膜凹陷征13例.囊腔CT特点:单纯囊腔3例、囊腔周围伴结节29例(伴实性结节7例、伴磨玻璃结节15例、伴混杂磨玻璃结节7例),其中囊腔位于主体病灶一侧12例,囊腔位于病灶内17例;多囊24例,囊壁不光整23例、腔内粗细不等分隔22例,血管穿行27例.结论含囊腔周围型肺癌在CT上表现特殊且多样,形态不规则、分叶征、多囊、囊壁不光整、腔内有分隔、血管穿行等恶性征象及其动态变化特点有一定的鉴别诊断价值;高或中分化腺癌易形成囊腔,囊腔的病理形成机制多样,肿瘤细胞伏壁生长阻塞末端支气管形成活瓣样结构,肺泡壁破坏、融合为其形成的主要机制.Objective To investigate CT features of peripheral lung cancer with cystic cavity.Methods The clinical,imaging and pathological data of 32 patients with cystic cavity lung cancer confirmed by pathology were analyzed retrospectively.Results The 32 patients included invasive adenocarcinoma in 28 cases(high-moderate differentiation in 12,moderate differentiation in 10 and moderate-low differentiation in 6).adenocarcinoma in situ in 2,and squamous carcinoma in 2.CT features of peripheral lung cancer included irregular shapes in 26 cases,lobulation in 30,speculation in 15,air bronchogram in 4,bronchial truncation in 4,vessel convergence in 11,and pleural indentation in 13.CT features of cystic cavity included isolated cystic cavity in 3 cases and wall nodules in 29 cases(7 cases with solid nodules,15 cases with ground glass nodules,and 7 cases with mixed nodules).Meanwhile,the cystic cavity of 12 cases were located in the side of lesions and other 17 cases were in the interior.In addition,multiple cystic cavity(24 cases).irregular inner wall(23 cases).septation(22 cases),and vascular passage(27 cases)were also found on CT.Conclusion CT manifestations of peripheral lung cancer with cystic cavity are characteristic and various,including irregular shape,lobulation,multiple cystic cavity,irregular inner wall,separation,and vascular passage.Together with the dynastic variation,the imaging features may have significant value for differential diagnosis.High-moderate differentiation adenocarcinoma tends to develop the cavities.The pathomechanism of cystic cavities are diverse,and the main mechanism is checkvalve obstruction at the terminal bronchiolar level by the tumor cells of adherent growth,then resulting in the alveoli rupture and fused cystic cavities.

关 键 词：囊腔 肺癌 计算机体层成像 

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