儿童支气管粘液表皮样癌的CT表现

Mucoepidermoid carcinoma of the tracheobronchial tree: CT findings in 11 children patients

目的探讨儿童支气管粘液表皮样癌的CT表现,以提高对其影像认识及诊断准确性。方法回顾性分析经病理证实的11例支气管粘液表皮样癌的CT影像、临床和病理资料。结果 11例中主要临床表现有咳嗽、咳痰、发热、胸闷、气促、胸痛和咯血。11例均为低级别分型。肿瘤发生于气管2例,主支气管2例,叶支气管6例,段支气管1例。直径约1~3cm。肿瘤呈无腔外浸润的宽基底类圆形结节5例,腔内外类圆形肿块状5例,腔内外条柱状1例。11例均进行了CT平扫及CT增强扫描,平扫肿瘤均接近或等于肌肉组织密度,6例肿瘤内有钙化;11例增强扫描肿瘤均呈明显强化,其中9例显示支气管动脉供血。11例中10例存在气管阻塞性肺改变。结论儿童支气管粘液表皮样癌多为低度恶性,好发于叶支气管,CT上多表现为边界清晰的气管腔内软组织密度占位,部分肿瘤可有钙化,强化明显,大部分可显示支气管动脉供血。

Objective To explore the CT findings of mucoepidermoid carcinoma of the tracheobronchial tree in children pa- tients and to improve the radiographic knowledge and diagnostic accuracy. Methods CT findings and clinical features of 11 his- topathologically proved mucoepidermoid carcinomas in 11 consecutive children were reviewed retrospectively. Results The clini- cal symptoms included cough, sputum, fever, wheezing, chest pain and hemoptysis. The patient was proved to be low-grade （n = 11 ） mucoepidermoid carcinoma histopathologically. 2 cases located in bronchus, 2 cases in main bronchus, 6 in lober bronchus, and one in segmental bronchus. The tumor presented as no-invasive endotracheobronchial well-defined round-like nodule （n = 5, 2 locating in lobar bronchus, 1 locating in main bronchus, 2 locating in bronchus）, or intra-and-extraluminal well-defined round- like nodule or mass （n = 5, locating in main and lobar and lower bronchus）, or intra-and-extraluminal irregular mass and colum- nar sharp （ n = 1, locating in lobar bronchus）. The density of lesion was similar to the muscle and the calcification within lesion was shown in 6 patient on non-enhanced CT. All the tumors had marked enhancement on enhanced CT. 9 cases showed bronchial artery supply. Obstructive changes were found in 10 cases. Conclusion Mucoepidermoid carcinoma of the tracheobronchial tree, usually located in lobar bronchus, appears at CT as well-defined lobulated airway mass, marked enhancement and calcification on CT. The bronchial arteries can be displayed in the most cases.