CT在原发性肺淋巴上皮瘤样癌诊断及疗效评估中的价值

Diagnostic and Therapeutic Evaluation Value of CT Imaging for Primary Pulmonary Lymphoepithelioma-Like Carcinoma

目的分析原发性肺淋巴上皮瘤样癌（LELC）的CT特征,探讨CT在肺LELC诊断及疗效评估中的价值。方法回顾性分析经病理确诊为肺LELC患者45例胸部CT平扫及增强资料,对比25例未行手术患者治疗前后CT改变。结果周围型22例,11例病灶内靠外可见充气细支气管,增强扫描12例病灶内见正常肺静脉或肺动脉走行。中央型23例,23例叶或段支气管截断,远端支气管闭塞,增强扫描15例病灶内见正常肺静脉或肺动脉走行。19例未手术患者治疗后好转表现为病灶体积缩小,其内支气管较前清楚、通畅,原病灶内走行血管游离出。结论支气管血管包埋可作为一个肺LELC较为特征性CT表现。肺LELC好转表现为肿瘤体积缩小,肿瘤包埋的支气管通畅,血管游离出。

Objective To investigate the CT imaging features of primary pulmonary lymphoepithelioma-like carcinoma（ LELC）,and to discuss its diagnostic and therapeutic evaluation value. Methods The CT plain scan and enhanced scan data from a total of 45 subjects diagnosed pathologically as pulmonary LELC were recruited in regression analysis,and 25 subjects with no operations were included in comparison of CT imaging changes before and after surgery. Results The CT imaging results detected 22 cases of peripheral LELC,among which 11 cases of air-bronchogram in the lateral of lesions and12 cases of pulmonary venous or arterial flow when enhanced; 23 cases of central LELC,among which 23 cases of bronchial truncation or distal bronchial occlusion and 15 cases of pulmonary venous or arterial flow when enhanced. 19 subjects with no operations recovered after treatment,for reduced lesion dimensions,more clear and ventilated endobronchus,and tortuous or disordered vessel liberation from lesions. Conclusion Bronchial vessel embedment is a characteristic CT imaging feature for pulmonary LELC. Reduced tumor dimension,ventilated tumor-embedded bronchus and liberated vessels were the signs of pulmonary LELC improvement.