原发性肺淋巴上皮瘤样癌的影像学表现:附10例报告及文献复习

Imaging features of primary pulmonary lymphoepithelioma-like carcinoma: report of 10 cases and literature review

目的探讨原发性肺淋巴上皮瘤样癌的影像学表现特点。方法回顾性分析经手术和（或）病理证实的10例肺淋巴上皮瘤样癌临床病理、X线胸片及CT扫描资料,并复习文献。结果临床主要表现为咳嗽、咳痰5例,咳血丝痰2例,胸闷3例,胸痛3例,发热2例,3例为体检发现,无明显症状。本组病例影像上主要表现为周围型肿块或结节,直径在2.3~12.4 cm。有浅分叶者7例,有毛刺征者3例,胸膜凹陷者3例。5例行CT增强扫描,肿块呈轻到中度,3例强化不均匀。结论肺淋巴上皮瘤样癌影像学有一定特征性,但X线与CT表现仅能提示诊断,术前确诊需经支气管内窥镜活检或经皮肺穿活检。

Objective To study the imaging features of primary pulmonary lymphoepitheliom-like carcinoma（LELC）.Methods Ten cases of primary pulmonary LELC were confirmed by surgery and pathology.The findings in clinical pathology,X-ray and CT were retrospectively analyzed and the related references were reviewed.Results The clinical manifestations included coughing（5 cases）,hemoptysis（2 cases）,chest distress（4 cases）,thoracodynia（3 cases）,and fever（2 cases）,with 3 cases being asymptomatic.Radiographically,primary pulmonary LELC appeared mainly as peripheral nodules or masses.The maximum diameter of the lesion was 2.3 to 12.4 cm.The lesions were slightly lobulated in 7 cases and spiky on the edge in 3 cases.Pleura retraction was shown in 3 cases.CT contrast scanning revealed light or significant enhancement in 5 cases.Conclusion Primary pulmonary LELC has some characteristic imaging features,but X-ray and CT only are not sufficient for a definite diagnosis,which still relies on bronchoscopic biopsy and percutaneous pulmonary puncture biopsy.