原发性肺淋巴上皮瘤样癌的CT表现:附14例报告及文献复习

CT Features of Primary Pulmonary Lymphoepithelioma-like Carcinoma:Report of 14 Cases and Literature Review

目的探讨原发性肺LELC的CT表现。方法回顾性分析我院经手术病理证实的14例原发性肺LELC的临床病理及CT资料。结果 CT主要表现为单发类圆形肿块,中央型10例,周围型4例;其中左肺8例,右肺6例;边界清楚,直径1.8-7.3cm,平均直径(5.01±2.12)cm。密度多均匀,肿块呈分叶征7例,边缘可见短毛刺4例,出现血管支气管包埋征5例,2例可见小斑点样钙化,其中4例合并阻塞性肺炎,9例伴有纵膈及肺门淋巴结肿大。增强扫描,本组14例中均匀强化9例,不均匀强化5例。结论原发性肺LELC的CT表现有一定特征性,但单凭CT诊断仍有一定困难,最终确诊还需依靠手术病理及免疫组化分析。

Objective To investigate the CT features of primary pulmonary lymphoepithelioma-like carcinoma. Methods Clinical information and CT findings were analyzed retrospectively in 14 patients with surgical pathology conformed pulmonary LELC. Results CT pulmonary LELC showed single mass,10 central tumors and 4 pripheral tumors. Among them 8 cases occurred in left lobe and 6 cases in right lobe. Fourteen tumors with diameters ranging from 1.8 to 7.3cm（mean,（5.01±2.12）cm） were identified. CT findings of pulmonary LELC consisted of well defined border,lobulation（7 cases）, speculation（4 cases）,vascular or bronchial encasement（5 cases）, solitary punctate calcification（2 cases）,obstructive pneumonia（4 cases） and lymphadenopathy in mediastinum or hilar（9 cases）. On contrast-enhanced CT, 9 patients had tumors with homogeneous enhancement,and 5 tumors showed inhomogeneous enhancement. Conclusion CT findings of primary pulmonary LELC have certain characteristics, but there are some difficulties in the diagnosis of CT alone, the final diagnosis needs to rely on pathology and immunohistochemistry.