肺肉瘤样癌的CT诊断及误诊分析

Analysis of misdiagnosis and CT features of pulmonary sarcomatoid carcinoma

目的探讨肺肉瘤样癌的CT表现特征。方法回顾性分析14例经病理证实肺肉瘤样癌CT资料,并与病理结果进行对照分析。结果 14例中12例为单发,2例为多发,中央型4例,周围型10例,病变平扫呈软组织密度,12例呈不均匀强化,内部有囊变坏死区,10例患侧胸膜肥厚,免疫组织化学14例均表达CK(+),Vim(+)。结论肺肉瘤样癌CT表现具有一定特征性,CT检查有助于肺肉瘤样癌的定位定性及明确肿瘤与周围组织结构的关系,为手术方案提供可靠的影像学依据。免疫组织化学CK和Vim对肺肉瘤样癌的诊断有决定性作用。

Objective To analyze CT features of pulmonary sarcomatoid carcinoma .Methods CT findings of 14 cases with pathologically proved pulmonary sarcomatoid carcinoma were retrospectively analyzed .Results There was a solitary mass in 12 cases .Multiple lesion was detected in 2 cases .Among these lesions ,4 cases were central type and 10 cases were peripheral type .All the masses had heterogeneous density on precontrast CT images .Masses with heterogeneous en-hancement were shown in 12 cases .Cystic and necrotic areas were noted within these masses .Pleural thickening on the af-fected side was detected in 10 cases .CK and Vim were positive in all the 14 cases .Conclusion CT is the modality of choice for diagnosis of pulmonary sarcomatoid carcinoma ,not only for tumor depicting ,but also for preoperative planning . CK and Vim might be definitively immunohisto-chemical diagnosis for pulmonary sarcomatoid carcinoma .