肺神经内分泌肿瘤的CT诊断与病理对照

CT and Pathological Features of Pulmonary Neuroendocrine Tumors

目的分析肺神经内分泌肿瘤的CT表现,并与病理分型对照,提高对该病的认识。方法回顾性分析本院2003年8月至2012年9月间诊治的32例肺神经内分泌肿瘤病例,对照分析CT表现与病理分型。结果 32例肺神经内分泌肿瘤包括4例典型类癌、4例不典型类癌、10例大细胞神经内分泌癌、14例小细胞肺癌。其中男27例、女5例,平均年龄54.9岁;中央型14例、周围型18例;肿瘤平均直径(32.145±13.335)mm,分叶征12例(37.5%),密度均匀23例(71.9%),增强扫描CT值增高(41.594±18.641)HU;合并纵隔及肺门淋巴结转移20例。结论肺神经内分泌肿瘤的CT表现与其病理特性相对应,典型类癌及不典型类癌影像表现有一定特点,大细胞神经内分泌癌及小细胞肺癌缺乏特征性影像表现,确诊最终依赖病理。

Objective To analyze CT and pathological features of pulmonary neuroendocrine tumors （PNETs） and improve its recognition. Methods From August 2003 to September 2012, 32 cases with histopathologically proven PNETs were retrospectively analyzed. CT and pathological features were compared. Results 32 cases included 4 typical carcinoid （TC）, 4 atypical carcinoid （AC）, l0 large cell neuroendocrine carcinoma （LCNEC）, 14 small cell lung carcinoma （SCLC）. Of all 32 cases, 27 men and 5 women, mean age was 54.9, the lesions included 14 central types and 18 peripheral types, average size of the tumors was （32. 145 ± 13. 335）ram, 12 lesions （37.5%） had lobulation sign, 23 lesions （71.9%） had isodensity, CT value increased 41. 594 ± 18. 641 HU on enhanced CT, and 20 cases had mediastinum and hilus lymph nodes metastasis. Conclusion CT image of PNETs are correspond to its pathological features. The image of TC and AC have some characteristic, but LCNEC and SCLC are lack of image characteristic and final diagnosis depends on pathology.