肺浸润性黏液腺癌的影像表现与病理对照

发布时间：2018-05-20 11:21

本文选题：肺浸润性黏液腺癌 + 体层摄影术　；参考：《临床放射学杂志》2017年09期

【摘要】：目的探讨肺浸润性黏液腺癌(PIMA)的CT和PET-CT表现及其病理特点。方法回顾性分析经手术病理或穿刺活检证实的26例PIMA患者的临床、影像及病理资料。26例患者均行CT平扫,其中23例行CT多期增强扫描;10例行PET-CT检查。观察其影像学表现并与病理进行对照。结果 26例PIMA中,单发结节或肿块19例,单发实变2例,多发结节或混合型5例。病灶最大径范围0.8~27.7 cm,平均(4.83±5.18)cm。病灶密度较低[平均(24.9±14.89)HU],增强后多呈轻中度强化。边缘光滑16例,分叶征16例,毛刺征8例,不完整晕征13例,空泡或假性空洞征8例,血管造影征3例,"卫星瘤"征1例,钙化2例。10例病灶氟代脱氧葡萄糖(FDG)摄取均明显增高,标准摄取量(SUV)最大值为2.5~16.5,平均8.31±4.88。26例均诊断为PIMA,镜下肿瘤细胞沿肺泡壁生长,呈黏液柱状,胞浆丰富,间质可见黏液形成,部分腺腔内可见黏液聚集。结论 PIMA的影像表现有一定的特征,CT平扫密度较低,病灶出现不完整晕征及晕环内间隔增厚、多发空泡征或假性空洞征、"卫星瘤"灶,增强后呈轻中度强化,有助于PIMA的诊断。
[Abstract]:Objective to investigate the CT and PET-CT features of pulmonary invasive mucinous adenocarcinoma (PIMA). Methods 26 cases of PIMA confirmed by operation and pathology were retrospectively analyzed. All the 26 cases underwent plain CT scan, and 23 cases were examined by multiphase enhanced CT scan and 10 cases by PET-CT. The imaging findings were observed and compared with pathology. Results in 26 cases of PIMA, 19 cases were single nodules or masses, 2 cases were single consolidation, 5 cases were multiple nodules or mixed type. The maximum diameter of the lesion was 0.827. 7 cm (mean 4.83 卤5.18 cm). The density of lesions was low [mean 24.9 卤14.89)HU], and most of them showed mild and moderate enhancement after enhancement. The margin was smooth in 16 cases, lobular sign in 16 cases, burr sign in 8 cases, incomplete halo sign in 13 cases, vacuole or pseudocavity sign in 8 cases, angiography sign in 3 cases, and "satellite tumor" sign in 1 case. The uptake of fluorodeoxyglucose (FDG) was significantly increased in 2 cases and 10 cases of calcification. The maximum value of standard uptake of suv was 2.5 卤16.5, with an average of 8.31 卤4.88.26 cases diagnosed as PIMA. The tumor cells grew along the alveolar wall under microscope, showing mucus columnar, rich cytoplasm and mucus formation. Mucus aggregation could be seen in part of the glandular cavity. Conclusion the imaging features of PIMA are low density of plain CT scan, incomplete halo sign and thickening of the interval in halo ring, multiple cavitation sign or pseudo-cavitation sign, and "satellite tumor", which is helpful for the diagnosis of PIMA.
【作者单位】：广州医科大学附属第一医院放射科;广州医科大学附属第一医院病理科;广州医科大学附属第一医院广州呼吸疾病研究所胸外科;
【分类号】：R730.44;R734.2

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