肺黏液表皮样癌的CT表现

CT manifestations of pulmonary mucoepidermoid carcinoma

目的探讨肺黏液表皮样癌的CT表现特点。方法回顾性分析11例经手术病理证实的肺黏液表皮样癌的CT表现。结果 10例为中央型,1例为周围型;形态分别为椭圆形(7例)、分叶状(2例)及不规则形(2例)。9例边界清楚,2例边缘毛糙。10例为实性病灶,1例为囊实性病灶。增强CT显示7例肿瘤实质部分密度较均匀,4例密度不均匀;其中5例密度明显高于胸壁肌肉,4例密度与胸壁肌肉相仿,2例密度明显低于胸壁肌肉。3例支气管腔内结节周围见环形低密度液体影,2例见周围新月形或环形气体影。所有病例在CT上均可见支气管狭窄或阻塞(8例见阻塞性肺炎,5例见远端支气管扩张伴黏液栓塞,5例见肺不张)。5例可见纵隔、肺门或支气管周围淋巴结肿大,1例见同侧肋骨转移。结论大部分肺黏液表皮样癌的CT表现具有一定特点,有助于术前诊断。

Objective To observe CT characteristics of pulmonary mucoepidermoid carcinoma.Methods CT features of 11 patients with pulmonary mucoepidermoid carcinoma confirmed by pathology after operation were analyzed retrospectively.Results CT images showed lesions in the central lung in 10 patients and in the peripheral lung in 1.The contour of the tumor might be oval（n=7）,lobulated（n=2） or irregular（n=2）,with a smooth margin in 9 cases or crude in 2.CT revealed solid tumor in 10 patients and cystic-solid in 1.Contrast enhanced CT images showed homogeneous（n=7） or heterogeneous（n=4） attenuation.The attenuation of tumor was much higher than that of the chest wall muscle in 5 cases,the same as in 4 cases,lower in 2 cases.Associated findings of distal bronchial dilatation with mucoid impaction（n=5）,postobstructive pneumonia（n=8） or atelectasis（n=5） suggested of endobronchial mass.Additional ancillary findings indicated endobronchial location of the tumors in areas of peripheral or a crescent of mucus（n=3）,as well as air（n=2） around the tumor.CT showed mediastinal,hilar or peribronchial lymph nodule enlargement in 5 patients,with metastatic carcinoma of rib in 1 lymph node enlargement lymph node enlargement.Conclusion Most pulmonary mucoepidermoid carcinomas show characteristic CT signs,which are helpful for preoperative diagnosis.