MSCT对原发性气管支气管腺样囊性癌的12例诊断及文献复习  

Diagnosis of primary tracheobronchial adenoid cystic carcinoma by MSCT in 12 cases and literature review

作　　者：葛晓东 龚明福 白奇之 赵刚 甘慧 戴书华 Ge Xiaodong;Gong Mingfu;Bai Qizhi;Zhao Gang;Gan Hui;Dai Shuhua(Department of Radiology,Xinqiao Hospital,Army Medical University,Chongqing 400037,China)

机构地区：[1]陆军(第三)军医大学第二附属医院放射科,重庆400037

出　　处：《中华肺部疾病杂志（电子版）》2022年第3期344-348,共5页Chinese Journal of Lung Diseases(Electronic Edition)

基　　金：陆军军医大学苗圃人才项目(2019R059)。

摘　　要：目的分析原发性气管支气管腺样囊性癌(tracheobronchial adenoid cystic carcinoma,TACC)的多层螺旋CT(multislice spiral computed tomography,MSCT)影像学征象、临床表现及文献复习,以提高TACC诊断率。方法回顾性分析我院2011年6月到2021年11月期间12例经病理确诊的气管支气管腺样囊性癌患者的临床资料及MSCT征象。结果12例气管支气管腺样囊性癌患者临床表现无特异性,以咳嗽、咳痰、呼吸困难及咯血最为常见。MSCT上气管支气管腺样囊性癌均为单发病例,6例位于气管,5例位于左主支气管,1位于右肺下叶支气管;9例为腔内外型,1例为弥漫浸润型;2例为周围结节型,肿瘤引起不同程度支气管狭窄,部分伴随阻塞性肺炎、肺不张;病变纵向浸润范围为21~60 mm,平均浸润长度为(37.7±11.8)mm,7例气管受侵范围>1/2环周;增强扫描呈轻-中度延迟强化;4例患者纵隔淋巴结肿大。结论气管支气管腺样囊性癌患者多见于中青年患者,沿气管支气管管壁浸润性生长,管壁不同程度增厚、呈结节状、息肉样凸向腔内,轻-中度延迟强化,MSCT征象具有一定特点,为其临床治疗提供依据。Objective To investigate the MSCT imaging and clinical manifestations of primary tracheobronchial adenoid cystic carcinoma,so as to improve the diagnosis rate of patients with this disease.Methods A retrospective analysis of the clinical data and MSCT signs of 12 patients with pathologically confirmed tracheobronchial adenoid cystic carcinoma in our hospital from June 2011 to November 2021.Results Among the 12 patients with adenoid cystic carcinoma,the onset was non-specific,and the most common clinical manifestations were cough,expectoration,hemoptysis and dyspnea.The tumors were all single on MSCT,and the lesions were located in the trachea in 6 cases,the left main bronchus in 5 cases,and the trachea in the right lower lobe in 1 case;9 cases were intracavitary type and 1 case was diffuse infiltration type.2 cases were peripheral nodular type.The lesions caused different degrees of bronchial stenosis,and some were accompanied by obstructive pneumonia and obstructive atelectasis.The longitudinal invasion ranged from 21 mm to 60mm,with an average infiltration length of(37.7±11.8)mm;The trachea was invaded more than 1/2 ring in 7 cases.Enhancement scan showed mild to moderate delayed enhancement.Mediastinal lymph nodes were enlarged in 4 patients.Conclusion Tracheobronchial adenoid cystic carcinoma is mostly seen in young and middle-aged patients.It grows infiltratively along the tracheobronchial wall,and the wall thickens to varying degrees,presenting nodular and poly-like protruding into the lumen,with mild to moderate delayed enhancement.MSCT signs have certain characteristics,which provide the basis for its clinical treatment.

关 键 词：气管肿瘤 气管支气管腺样囊性癌 多层螺旋CT 影像诊断 

分 类 号：R734.2[医药卫生—肿瘤]