摘要
目的探讨肺大细胞神经内分泌癌(LCNEC)的MSCT表现。方法回顾性分析27例经手术病理证实为LCNEC患者的MSCT影像与病理资料。所有患者术前均接受胸部CT平扫,其中20例接受增强扫描。结果 23例表现为肺内单发肿块,4例表现同侧肺内为多发结节;26例为周围型,仅1例为中央型;肿块或结节最大径为1.2～14.2cm[平均(5.2±2.1)cm]。主要CT征象:肿块或结节边缘光滑20例(20/27,74.07%),肿块内片状坏死9例(9/27,33.33%)、点状钙化2例(2/27,7.41%);分叶征19例(19/27,70.37%),毛刺征13例(13/27,48.15%),空泡征3例(3/27,11.11%),胸膜牵拉征7例(7/27,25.93%),伴肺内阻塞性病变4例(4/27,14.81%)。增强后20例病灶均呈不均匀强化。14例(14/27,51.85%)可见同侧肺门或纵隔、隆突下淋巴结肿大,其中8例病理证实为淋巴结转移。1例(1/27,3.70%)肿块累及胸壁,1例(1/27,3.70%)发生骨转移,1例(1/27,3.70%)发生脑转移,1例(1/27,3.70%)发生全身转移。结论 LCNEC影像学表现复杂,缺乏特征性,诊断需结合病理学。
Objective To observe MSCT findings of lung large cell neuroendocrine carcinoma （LCNEC）. Methods MSCT and pathologic findings of 27 patients with LCNEC were reviewed. All patients received plain CT , while 20 of them received enhanced CT scan. Results LCNEC presented as single lung mass in 23 patients, while as multiple nodules of unilateral lung in 4 patients, which located peripherally in 26, but centrally only 1 patient, with diameters ranged from 1.2 to 14.2 cm （average cm）.The tumors were smooth and well defined in 20 cases （20/27, 74.07%）, while necrosis was found in 9 cases （9/27, 33.33%）and calcification was detected in 2 cases （2/27, 7.41%）. Lobulation of tumors was noticed in 19 cases （19/27, 70.37%）, spiculation was observed in 13 cases （13/27, 48.15%）, while vacuoles, pleural traction , obstructive atelectasis or pneumonia were found in 3（3/27, 11.11%）, 7（7/27, 25.93%）and 4 cases（4/27,14.81%）, respectively. After injection of contrast agent, irregular enhancement of tumors was observed in all 20 cases that underwent enhanced CT scan. Mediastinal or hilar lymphadenectasis were observed in 14 cases （14/27, 51.85%）, among which 8 cases were proved as metastasis. Adjacent chest wall invasion, bone metastasis or brain metastasis was detected in 1 case （1/27, 3.70%）, respectively. While whole body metastasis was found in 1 case （1/27, 3.70%）. Conclusion The imaging features of LCNEC were very complicated and lack of characteristic. The final diagnosis depends on combining imaging and pathology.
出处
《中国医学影像技术》
CSCD
北大核心
2013年第1期79-83,共5页
Chinese Journal of Medical Imaging Technology
关键词
肺肿瘤
癌
神经内分泌
癌
大细胞
体层摄影术
X线计算机
Lung neoplasms
Carcinoma, neuroendocrine
Carcinoma, large cell
Tomography, X-ray computed
