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。
Objective To observe MSCT and pathological features of primary pulmonary lymphoepithelioma-fike carci- noma (LELC). Methods Clinical data, pathological findings and CT materials of 15 patients with pathologically-proved primary pulmonary LELC were retrospectively analyzed. Before operation, all patients received plain chest CT scan, and additional enhanced CT scan was employed in 10 patients. Results Primary pulmonary LELC of central type was con- firmed in 10 cases and peripheral type in 5 cases. The maximum diameters of the tumors ranged from 2.2 to 10.2 cm with a mean of (4.8 ±2.3) cm. On CT scan, the tumor showed clear margin (12/15, 80% ) , shallow lobulation (11/15, 73.3% ), vascular convergence sign (2/15, 13% ), flack necrosis within tumor (4/15, 26.7% ) and obstructive pneu- monia (6/15, 40% ). On contrast-enhanced scan, the lesion displayed inhomogeneous enhancement (8/10, 80% ) and "vascular encasement" sign (6/10, 60% ) , the latter was more commonly seen in the tumor with inhomogeneous enhance- ment. Pulmonary hilar, mediastinal, infra-carinal lymphadenopathy was seen in 9 cases (60%) , in 6 of them lymphatic metastasis was confirmed by pathological examination. Distant metastases such as liver, bone, etc. were proved by PET-CT in 2 cases. Positive rate of EBER was 100% (4/4). Conclusion Primary pulmonary LELC often appears as a large mass with shallow lobulation, and is of central type in most cases. On contrast-enhanced CT scan, the tumor displays inho- mogeneous enhancement and "vascular encasement" sign. As this tumor is lack of specific CT features, the confirmation of the diagnosis depends on pathological examination.
出处
《临床放射学杂志》
CSCD
北大核心
2015年第2期208-211,共4页
Journal of Clinical Radiology
关键词
淋巴上皮样癌
肺癌
体层摄影术
X线计算机
Lymphoepithelioma-like carcinoma Lung cancer Tomography,X-ray computed