郭健,叶兆祥,冯小伟,尹全乐.肺大细胞神经内分泌癌的MSCT表现[J].中国医学影像技术,2013,29(1):79~83
肺大细胞神经内分泌癌的MSCT表现
MSCT findings of lung large cell neuroendocrine carcinoma
投稿时间:2012-05-23  修订日期:2012-09-06
DOI:
中文关键词:  肺肿瘤  癌,神经内分泌  癌,大细胞  体层摄影术,X线计算机
英文关键词:Lung neoplasms  Carcinoma, neuroendocrine  Carcinoma, large cell  Tomography, X-ray computed
基金项目:
作者单位E-mail
郭健 天津医科大学附属肿瘤医院放射科 天津市"肿瘤防治"重点实验室, 天津 300060天津港口医院放射科, 天津 300456  
叶兆祥 天津医科大学附属肿瘤医院放射科 天津市"肿瘤防治"重点实验室, 天津 300060 yezhaoxiang@163.com 
冯小伟 天津医科大学附属肿瘤医院放射科 天津市"肿瘤防治"重点实验室, 天津 300060  
尹全乐 天津港口医院放射科, 天津 300456  
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中文摘要:
      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。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。
英文摘要:
      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.
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