肺少见神经内分泌癌的CT表现

发布时间：2018-07-13 13:22

【摘要】：目的典型类癌、不典型类癌及大细胞神经内分泌癌属肺内少见神经内分泌肿瘤,因其肿瘤形态学及生物学行为各异,临床预后有较大差异。文中结合对比病理诊断结果,探讨肺少见神经内分泌癌的特征性CT表现。方法回顾性分析南京中医药大学附属医院2010年1月至2016年12月经病理证实的22例肺少见神经内分泌癌临床资料、CT表现及病理学特征,并进行差异性比较。结果本组病例中,男13例、女9例,中央型12例、周围型10例,出现钙化灶7例、坏死灶10例,合并支气管阻塞征象6例、淋巴结转移5例、远处转移1例。典型类癌发病年龄较轻,不典型类癌与大细胞神经内分泌癌发病年龄较大(P=0.003);典型类癌以中央型多见(P=0.044),多表现为支气管腔内结节(P=0.005),边缘光滑(P=0.000),常合并阻塞性肺炎及肺不张(P=0.019),无胸膜受累;不典型类癌以中央型多见,多表现为肺门处的分叶状软组织肿块,典型者呈长条形或"冰山征",阻塞征象少见,无明显胸膜受累;大细胞神经内分泌癌以周围型多见,病灶边缘有分叶征(P=0.000),无明显阻塞征象,常累及胸膜(P=0.000)。结论肺少见神经内分泌癌的临床及CT征象具有一定的特征性,需结合组织病理学及免疫组化检查进行确诊。
[Abstract]:Objective typical carcinoid, atypical carcinoid and large cell neuroendocrine carcinoma are rare neuroendocrine tumors in the lung. The CT findings of rare neuroendocrine carcinoma of the lung were studied. Methods the CT findings and pathological features of 22 cases of rare neuroendocrine carcinoma of the lung confirmed by pathology from January 2010 to December 2016 in affiliated Hospital of Nanjing University of traditional Chinese Medicine were analyzed retrospectively and the differences were compared. Results there were 13 males, 9 females, 12 cases of central type, 10 cases of peripheral type, 7 cases of calcification, 10 cases of necrosis, 6 cases of bronchial obstruction, 5 cases of lymph node metastasis and 1 case of distant metastasis. The typical carcinoid is younger, Atypical carcinoid and large cell neuroendocrine carcinoma (P0. 003) were more common in central type (P0. 044), most of them were endobronchial nodule (P0. 005), smooth margin (P0. 000), often complicated with obstructive pneumonia and atelectasis (P0. 019), no pleural involvement. Atypical carcinoid is more common in the central type, with lobular soft tissue masses in the hilar lung, typical of which is long strip or "iceberg sign", with few obstructive signs and no obvious pleural involvement, and large cell neuroendocrine carcinoma is more common in peripheral type. There was lobulation sign (P0. 000) at the edge of the lesion, no obvious obstruction sign and pleura was often involved (P0. 000). Conclusion the clinical and CT features of rare neuroendocrine carcinoma of the lung are characteristic, which need to be confirmed by histopathology and immunohistochemical examination.
【作者单位】：南京中医药大学附属医院放射科;
【分类号】：R730.44;R734.2

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