原发性肺黏液腺癌的临床表现及CT征象

Clinical manifestations and CT features of primary pulmonary mucinous adenocarcinoma

目的探讨原发性肺黏液腺癌(PPMA)的临床表现及CT征象。方法收集经病理证实的27例PPMA患者的临床资料及影像资料,归纳总结其临床表现及CT特征。结果 27例患者中,仅2例(2/27,7.41%)表现为典型的咳白色泡沫痰,余无特异性表现,其中13例(13/27,48.15%)患者体检发现病灶。27例患者共检出28个病灶,24个(24/28,85.71%)为周围型,4个(4/28,14.29%)为中央型。实性病灶15个(15/28,53.57%),囊实性10个(10/28,35.72%),磨玻璃结节3个(3/28,10.71%);病灶内空泡征11个(11/28,39.29%),短毛刺10个(10/28,35.72%),浅分叶11个(11/28,39.29%),胸膜侵犯3个(3/28,10.71%)。对10例患者行增强扫描,9例表现为轻度强化,1例为中度强化。27例患者中11例(11/27,40.74%)发生淋巴结或/和脑、骨、胸膜转移。结论 PPMA临床症状不典型,CT表现有一定的特异性、对提高其早期诊断率有一定的帮助。

Objective To explore the clinical symptoms and CT features of primary pulmonary mucinous adenocarcinoma （PPMA）. Methods Twenty-seven PPMA patients proved by pathology were selected. The clinical and CT imaging data were collected and analyzed. Results Among the 27 patients, only 2 patients （2/27, 7.41%） had the typical white foamy sputum, while the others had no specific clinical symptoms. Lesions were detected in 13 patients （13/27, 48.15%） in physical examination. A total of 28 lesions had been found in 27 patients, among which 24 lesions （24/28, 85.71%） were peripheral and 4 lesions （4/28, 14.29%） belonged to central type. There were a variety of lesion forms, among which 15 （15/28, 53.57%） were solid lesions, 10 （10/28, 35.72%） were solid cystic lesions, 3 （3/28, 10.71%） were ground glassnodule, 11 lesions （11/28, 39.29%） demonstrated visible cavity or follicular bubble, 10 lesions （10/28, 35.72%） had short speculation, and 11 lesions （11/28, 39.29 %） had superficial lobe. However, only 3 （3/28, 10.71%） pleural in- vasion had been detected. Totally 10 patients underwent enhanced scan, 9 of which demonstrated mild enhancement, and only one showed moderate enhancement. Eleven out of the 27 patients （11/27, 40.74%） had lymph node, brain, bone, pleural or other metastasis. Conclusion The clinical symptoms of PPMA are not typical. CT has specificity to some extent and is helpful in improving the early diagnostic rate.