肺癌肉瘤的CT表现与病理对照  

CT Imaging of Pulmonary Carcinosarcoma Compared with Pathology

作　　者：刘江勇[1] 李武超 刘新峰[1] 王骋[1] 曾宪春[1] 王荣品[1] LIU Jiangyong;LI Wuchao;LIU Xinfeng(Department of Radiology,Guizhou Provincial People's Hospital,Guiyang,Guizhou Province 550002,P.R.China)

机构地区：[1]贵州省人民医院医学影像科,贵阳550002

出　　处：《临床放射学杂志》2023年第8期1255-1258,共4页Journal of Clinical Radiology

基　　金：贵州省卫健委科学技术基金项目(编号:gzwjkj2017-1-067,gzwkj2021-373);贵州省科技成果应用及产业化计划项目(编号:黔科合成果-LC[2023]022)。

摘　　要：目的探讨肺癌肉瘤(PCS)的CT表现与病理对照,提高对该病的认识。方法回顾性分析10例经手术及病理证实的PCS CT表现并与病理进行对照。结果10例PCS中:位于左肺4例,右肺6例;中央型2例,周围型8例。CT表现具有癌及肉瘤双重特征,中央型表现为肺门区肿块,肿块形态不规则、分叶状,可见阻塞性肺炎;周围型表现为大小不等类圆形肿块,可见毛刺征及分叶征,1例肿块内见空洞,增强扫描肿块实性部分呈不均匀强化,且呈渐进性强化。病理表现为肿瘤浸润支气管壁及周围肺组织,可见脉管内癌栓、神经侵犯及淋巴结转移。结论PCS的CT表现具有癌及肉瘤双重影像特征,增强扫描肿块实性部分呈不均匀强化,且有渐进性强化的特点,该特点有助于提高PCS术前诊断准确率,确诊仍需组织病理学检查。Objective To investigate the CT features of pulmonary carcinosarcoma compared with pathology,raise awareness of the disease.Methods CT findings of 10 cases with pulmonary carcinosarcoma proved by operation and pathology were analyzed retrospectively,and compare with pathology.Results In 10 cases of pulmonary carcinosarcoma:Left lung in 4 cases,right lung in 6 cases;There were 2 cases of central tumors and 8 cases of peripheral tumors.CT findings showed double features of cancer and sarcoma.The central tumors was an irregular,lobulated mass in the hilar region,with obstructive pneumonia.The peripheral tumors showed round masses of different sizes,with spicule sign and lobulation sign.1 case had a cavity in the mass.The solid portion of the mass on contrast-enhanced scan showed uneven enhancement and progressive enhancement.Pathological findings showed tumor infiltrating bronchial wall and surrounding lung tissue,intravascular tumor thrombus,nerve invasion and lymph node metastasis.Conclusion CT findings of pulmonary carcinosarcoma showed double features of cancer and sarcoma.The solid portion of the mass on contrast-enhanced scan showed uneven enhancement and progressive enhancement.This feature is helpful to improve the accuracy of preoperative diagnosis of pulmonary carcinosarcoma,but histopathological examination is still needed to confirm the diagnosis.

关 键 词：肺癌肉瘤 体层摄影术 X线计算机 病理学 

分 类 号：R734.2[医药卫生—肿瘤] R730.44[医药卫生—临床医学]