原发性支气管肺类癌的CT表现与病理对照.docVIP

原发性支气管肺类癌的CT表现与病理对照 丁春华 黄新锐 雷明志 方胜平 段 超 唐 亮 【摘要】 目的 回顾性分析原发性支气管肺类癌的CT表现与病理特征，提高对此病的认识。 方法 24例经病理及免疫组织化学检查证实的肺类癌患者，男19例，女5例，年龄38～71岁（平均51.2岁）。其中16例经手术病理证实，4例经CT导向下穿刺活检证实，4例经纤维支气管镜活检证实。24例患者中22例行平扫及增强检查，2例仅行平扫CT检查。 结果 24例患者中，中央型类癌9例，周围型类癌15例。CT表现为单发肿块或结节病灶的19例，多发结节或肿块的5例，其中1例表现为6个大小不等结节呈簇状分布，4例表现2个大小不等肿块，分布于同一侧肺的不同肺段或肺叶。24例患者共33个病灶，病灶最大径0.5～13.2cm。CT平扫表现为密度均匀10例，密度不均匀14例，其中11例病变内大小不等低密度坏死灶，3例肿块内见颗粒状钙化；肿块边缘毛刺状13例，边缘无明显毛刺的11例；纵隔及肺门淋巴结肿大8例。22例行增强扫描的病例均显示为中等至明显强化，均匀或不均匀。24例患者均行HE染色及免疫组织化学检查，结果显示6例不典型类癌，18例典型类癌。CT上显示8例有纵隔或肺门淋巴结肿大者，病理仅提示4例有转移，其余4例为炎性肿大淋巴结。 结论 肺类癌具备一些特征性的临床和影像学特征，对影像学征象的分析并结合临床特征可提高对本病的诊断。 【关键词】 原发性支气管肺类癌 CT 病理特征 【Abstract】 Objective To analyze CT and pathological features of primary pulmonary carcinoid and to explore the pathological foundation of its CT manifestations. Methods The data from 24 cases of primary pulmonary carcinoid diagnosed by surgery and pathology were retrospectively studied, and the features in CT scan and pathology were analyzed. Results In this study, there were 9 cases of central carcinoid tumor and 15 cases of peripheral tumor. Solitary mass or nodule was showed in 19 cases and multiple masses in 5 cases. The maximum diameter of the lesions was 0.5 to 13.2cm.The lesions were spiculated in 13 cases and regular in 11 cases. Calcification was found in 3 cases. 22 cases received enhancement scanning, and showed moderate or obvious enhancement. All cases were diagnosed by pathology and immunohistochemistry. They showed atypical carcinoid in 6 cases and typical carcinoid in 18 cases. Conclusion The features of pulmonary carcinoid in CT scan are in accordance with their pathology. The features are helpful in using CT to diagnose primary pulmonary Carcinoid. 【Key words】 Primary pulmonary Carcinoid CT Pathology 中图分类号：R322.3+5 文献标识码：A 文章编号：1815-1248(2010)07-0038-04 支气管肺类癌是来源于支气管上皮组织嗜银细胞的恶性肿瘤，故又称支气管嗜银细胞瘤，肿瘤内含有神经内分泌颗粒，属肺部低度恶性肿瘤，较少见。与肺癌相比，其病程缓慢，生存期长，预后较好。笔者对2006年6月～201