胸腺类癌的CT表现及相关文献复习

CT manifestations of the thymic carcinoid and literature review

目的分析胸腺类癌的CT表现,探讨其诊断价值。方法回顾性分析5例经临床病理证实的胸腺类癌患者的临床及CT资料,分析其CT表现并结合文献复习。结果5例胸腺类癌患者临床表现无特异性,均未见合并类癌综合症;肿瘤体积均比较大(肿瘤最大层面平均大小为11.7cm×7.6cm),密度不均匀,肿瘤内部可见低密度坏死或囊变区,均未见高密度钙化灶,增强扫描肿瘤呈轻中度不均匀强化,内部可见小"线状"强化血管影,肿瘤包膜不完整,4例可见临近大血管(上腔静脉2例、头臂静脉4例)受侵犯,5例患者均见锁骨上和/或纵隔内淋巴结转移,均未见肺野及其他远处血行转移的征象。结论胸腺类癌CT表现具有一定的特征性,对术前正确诊断有一定帮助。

Objective To investigate the CT manifestations of thymic carcinoid and assess the diagnostic value of CT for this disease. Methods CT and clinical findings of 5 patients （4 males and 1 female, average age 41 years） with histologically confirmed thymic carcinoid were retrospectively analyzed. Results The clinical findings of the 5 patients showed no specificity, and none of the patients presented with carcinoid syndrome. The tumors were relatively large （mean size on the largest planar of 11.7 cm×7.6 cm） with heterogeneous density, and showed necrosis or cystic degeneration in the tumor. The lesions showed uneven enhancement in contrast-enhanced imaging and displayed linear enhancement of the blood vessels in the tumors in 3 cases with unclear tumor margins. The adjacent major vessels were displayed in 4 cases （the superior vena cava in 2 and brachiocephalic vein in 4 cases）, and 5 showed mediastinal and/or root of the neck lymphatic metastasis. None of the cases have lung or other site metastasis. Conclusion The CT findings of the thymic carcinoid have some characteristics, and can be helpful in the diagnosis.