胸腺神经内分泌肿瘤的CT表现及临床特征分析  

CT and clinical features of thymic neuroendocrine tumor

作　　者：雷小燕 黄薇园 杨凯[1] 王振平[1] 陈峰[1] LEI Xiaoyan;HUANG Weiyuan;YANG Kai;WANG Zhenping;CHEN Feng(Department of Radiology,Hainan General Hospital,Haikou 570000,Hainan Province,China)

机构地区：[1]海南省人民医院放射科,海南海口570000

出　　处：《肿瘤影像学》2022年第2期161-166,共6页Oncoradiology

摘　　要：目的:探讨胸腺神经内分泌肿瘤(thymic neuroendocrine tumor,TNET)的计算机体层成像(computed tomography,CT)影像学表现及临床特征,以提高对TNET的认识。方法:回顾并分析22例经病理学检查证实的TNET患者的临床及CT影像资料,所有患者均行CT平扫及增强检查,CT图像分析内容包括病变位置、大小、形态、密度、囊变、坏死、钙化、强化模式、周围组织侵犯、纵隔或肺门淋巴结转移(短径>10 mm)及远处转移。结果:病理学分型:典型类癌1例,不典型类癌14例,小细胞癌3例,大细胞癌4例。CT表现:病变主体均位于前纵隔,轴位最大径2.4~10.0 cm,中位最大径6.2 cm。类圆形8例,分叶状形5例,不规则形9例。4例密度均匀,18例密度不均匀,其中17例伴坏死,5例伴囊变,6例伴钙化。增强扫描14例呈轻度强化,7例中度强化,1例呈高度强化,6例可见线状强化血管影。周围组织侵犯:侵犯胸膜12例,侵犯心包13例,侵犯邻近肺组织10例,18例不同程度侵犯纵隔大血管。纵隔淋巴结转移11例,2例出现锁骨上窝、心膈角区及腹膜后淋巴结转移,4例肺内转移,3例胸膜转移。结论:TNET多见于老年男性患者,CT多表现为前纵隔较大肿块,坏死常见,增强扫描多呈轻-中度强化,肿瘤侵袭性强,易侵犯周围结构,转移较常见。CT对TNET的鉴别诊断及术前评估具有重要价值。Objective:To investigate the computed tomography(CT)and clinical features of thymic neuroendocrine tumor(TNET)and improve the diagnostic accuracy of TNET.Methods:The clinical and CT data of 22 patients with TNET confirmed by histopathology were retrospectively reviewed.CT images were analyzed,included lesion location,size,shape,density,cystic degeneration,necrosis,calcification,pattern of enhancement,surrounding tissue invasion,mediastinal or hilar lymph node metastasis(short diameter>10 mm)and distant metastasis.Results:According to the histopathology results,there were 1 case of typical carcinoid,14 cases of atypical carcinoid,3 cases of small cell carcinoma,and 4 cases of large cell neuroendocrine carcinoma.CT features:the lesions were mainly located in the anterior mediastinum,and the median maximum diameters of lesions were 6.2 cm(range 2.4-10.0 cm)in the axial images.5 lesions were lobulated,9 lesions were irregular shape and 8 lesions were round-alike.4 lesions with uniform density and 18 lesions with uneven density.17 cases contained necrosis,5 cases contained cystic degeneration and 6 cases contained calcification.Enhanced CT scan:14 cases showed mild enhancement,7 cases showed moderate enhancement and 1 case showed significant enhancement,6 cases showed intratumoral blood vessels.Surrounding tissue invasion:there were 12 cases of pleura invasion,13 cases of pericardium invasion,10 cases of pulmonary invasion,18 cases of mediastinal vessels invasion.There were 11 patients with mediastinal lymph node metastasis,2 patients with supraclavicular fossa,heart phrenic horn area and retroperitoneal lymph node metastasis,4 patients with lung metastasis and 3 patients with pleural metastasis.Conclusion:TNET is more common in elderly male patients,the CT findings of TNET are masses with large anterior mediastinal volume,and the necrotic cystic changes are common.There is mild to moderate enhancement in post-contrast scan,the tumor is aggressive and tends to invade the surrounding structures and the metastasis is co

关 键 词：胸腺 神经内分泌肿瘤 计算机体层成像 胸腺肿瘤 

分 类 号：R734.5[医药卫生—肿瘤] R455.3[医药卫生—临床医学]