肺不典型类癌的CT表现分析

CT Analysis of the Bronchial Atypical Carcinoid Tumor

目的探讨肺不典型类癌的临床和CT特征,进一步认识该病,提高诊断正确率。方法收集本院经术前CT扫描和病理证实的肺不典型类癌8例,对其CT征象、临床表现和病理结果进行回顾性分析。结果 8例肺不典型类癌均为单发病灶,6例咳嗽,其中3例伴咳血丝痰或咯血;另2例体检发现;均未见类癌综合征。1例纵隔淋巴结转移,4例远处转移。CT表现周围型6例,均有分叶,其中2例呈典型"冰山征"表现;中央型2例,均伴有阻塞性肺炎和肺不张。钙化2例,空洞未见。病灶平均直径4.8cm,增强后5例见中重度强化。结论肺不典型类癌临床症状无明显特异性,CT常表现为周围型单一病灶,分叶多见,出现钙化为一重要特征,"冰山征"表现有助于诊断。

Objective To investigate the clinical and CT features of the bronchial atypical carcinoid tumor,in order to have a full realization of the disease and improve the accurate rate of diagnosis.Methods Preoperative CT features,clinical and pathological data of the bronchial atypical carcinoid tumor in eight cases were collected and analyzed retrospectively.Results All the eight cases were solitary masses,6 cases had cough symptom,thereinto 3 cases had hemoptysis;while 2 masses were detected occasionally without any discomfort.There was no carcinoid syndrome in all patients.The lymph node metastasis and distant metastasis were found in one case and 4 cases respectively.On CT images,6 neoplasms were located in the peripheral lung,all lobulated,of which 2 nodules revealed ＂iceberg＂ signs.Other two central bronchial atypical carcinoids were seen with bronchial obstruction in them,such as obstructing pneumonitis and associated atelectasis.Calcification was present in 2 cases,while no cavity in all.The average size was 4.8cm in diameter.On CT contrast scanning,5 nodules showed significant enhancement.Conclusion As to bronchial atypical carcinoid tumor,the clinical symptoms has no particularity.The CT images often show peripheral solitary neoplasms with lobulated sign,calcification is a characteristic sign of the tumor,and the ＂iceberg＂ sign is helpful for the diagnosis.