肺原发性淋巴上皮样癌的MSCT表现及病理分析

发布时间：2018-07-16 23:30

【摘要】：目的探讨肺原发性淋巴上皮样癌(LELC)的MSCT表现并分析其病理学基础。方法回顾性分析15例经病理证实为肺原发性LELC的临床、病理及影像资料。所有患者术前均行胸部CT平扫,其中10例行增强扫描。结果中央型10例,周围型5例,最大径约2.2~10.2 cm,平均(4.8±2.3)cm。CT表现:边界清晰12例(80%),呈浅分叶状11例(73.3%),血管纠集征2例(13.3%),肿块内片状坏死者4例(26.7%),阻塞性肺炎6例(40%)。增强扫描大部分肿块不均匀强化(8/10,80%),并且"包绕血管征"(6/10,60%)在不均匀强化肿块中更多见。9例(60%)见肺门或纵隔、隆突下淋巴结肿大,其中6例经病理证实为淋巴结转移,PET-CT证实2例发生肝、骨等远处转移。EBER阳性率为100%(4/4)。结论肺原发性LELC多表现为体积较大、中央型、浅分叶的肿块,增强扫描不均匀强化并可见"包绕血管征"。本病CT表现缺乏特征性,确诊依靠病理学检查。
[Abstract]:Objective to investigate the MSCT findings of primary lymphoid epithelioid carcinoma (LELC) of the lung and to analyze its pathological basis. Methods the clinical, pathological and imaging data of 15 cases of primary pulmonary LELC proved pathologically were retrospectively analyzed. All patients underwent plain chest CT scan before operation, 10 of them underwent enhanced CT scan. Results in 10 cases of central type, 5 cases of peripheral type, the maximum diameter was about 2.2 卤10.2 cm (mean 4.8 卤2.3 cm). Ct findings showed clear boundary in 12 cases (80%), superficial lobular shape in 11 cases (73.3%), vascular collation sign in 2 cases (13.3%), flake necrosis in 4 cases (26.7%), obstructive pneumonia in 6 cases (40%). Most of the masses were inhomogeneously enhanced (8 / 1080%), and the "encircling vascular sign" (6 / 1060%) was more common in 9 cases (60%) with hilar or mediastinal enlargement, and subcarinal lymph node enlargement. The positive rate of EBER was 100% (4 / 4) in 6 patients with metastatic lymph nodes confirmed by PET-CT. Conclusion Pulmonary primary LELC is characterized by large volume, central type, superficial lobular mass, uneven enhancement of enhanced scan and "encircling vascular sign". The CT findings of this disease lack of characteristic, the diagnosis depends on pathological examination.
【作者单位】：南方医科大学南方医院影像中心;南方医科大学南方医院病理科;
【分类号】：R734.2;R730.44

【参考文献】