空洞型肺癌的16层螺旋CT表现与病理对照分析

Cavernous Lung Cancer:16-slice CT-pathologic Correlation

目的结合病理结果,分析空洞型肺鳞状细胞癌(鳞癌)、肺腺癌CT影像表现。方法收集2013-06月以来经肺穿刺、支气管镜活检或手术后病理证实的空洞型肺癌22例,其中包括肺鳞状细胞癌12例、肺腺癌10例,回顾性分析16层螺旋CT图像并对两种不同病理类型空洞型肺癌的影像学特点进行比较。结果 12例空洞型肺鳞状细胞癌以类圆形厚壁空洞为特点[瘤体直径(42±27)mm;壁厚(8.6±3.4)mm],空洞内伴有积液5例,出现壁结节、癌梁分隔者各2例,所有患者空洞周围均无胸膜线或毛刺征。10例空洞型肺腺癌瘤体直径(35±14)mm;壁厚(5.4±2.7)mm,8例病灶外缘伴有毛刺征,7例内壁有明显的壁结节,各肺腺癌空洞内均无积液表现。与空洞型肺鳞状细胞癌比较,空洞型肺腺癌病灶小、空洞壁更薄,出现壁结节、毛刺征概率明显增加,二者比较差异具有统计学意义(P<0.05)。结论不同病理类型空洞型肺癌CT表现有一定特征性,空洞型肺鳞状细胞癌多呈厚壁环形空洞,而空洞型肺腺癌外形不规则、空洞壁较薄且常伴有毛刺、壁结节征。

Objective To analyze the 16-silce CT-pathologic correlation of cavernous lung squamous cell carcinoma （SCC） and lung adenocarcinoma. Methods Twenty-two cases of cavernous lung cancer diagnosed by lung biopsy, bron- choscopy biopsy or postoperative pathology were collected since June 2013, including 12 lung SCC cases and 10 lung ade- nocarcinoma cases. The CT images were restrospectively analyzed, and the characteristics of cavernous lung cancer be- tween two different pathological types were compared. Results Cavernous SCC possessed the characteristic of quasi-circu- lar thick-walled cavity rtumor diameter, （42±27） mm; thickness, （8. 6±3. 4） mm]. Among 12 lung SCC cases, cavity fluid presented in 5 cases, wall nodule in 2 cases, and cavernous septa in 2 cases. No pleural line or spiculation were found in cavity of all patients. Among 10 cavernous ad I-tumor diameter, （35±14） mm; thickness, （5.4±2. 7） mm, spicule sign appeared in 8 cases, wall nodule in 7 cases, and no liquid loading were found in all cavities. Compared with cavernous lung SCC, lesions in cavernous lung adenocarcinoma were smaller with thinner wall （P〈0. 05）. The probabilities of wall nodule and spicule sign in cavernous lung adenocarcinoma were more than these in cavernous lung SCC （P〈0. 05）. Conclusion The CT manifestations of cavernous lung SCC and adenocarcinoma show some characteris- tics. Generally, cavernous lung SCC always presents as quasi-circular thick-walled cavity, and cavernous ad is irreuular in shade, thin-walled with snicule sign and mural nodules.