气管支气管少见原发肿瘤的影像分析

Analysis of the imaging features of the rare primary tumors in trachea and bronchus

目的:探讨气管支气管少见原发肿瘤的影像分析思路。方法:回顾性分析16例气管支气管少见原发肿瘤的临床和CT表现(5例仅平扫,7例仅增强,4例平扫加增强检查),并与手术病理进行对照分析。结果:16例中,7例为腺样囊性癌多发生于中年人(平均年龄43.4岁),其中6例位于气管,表现为宽基底结块,呈均匀的等密度;4例为黏液表皮样癌多发生于青年人(平均年龄34.8岁),多位于叶、段支气管,表现为腔内或腔内外结节或肿块;2例为不典型类癌,均为老年患者(平均年龄63岁),均位于右侧支气管,表现为沿支气管蔓延的肿块,1例呈特征性的"冰山征",CT增强明显均匀强化;1例为少见的中央型肉瘤样癌,表现为支气管腔内外沿支气管蔓延的肿块,轻度强化;2例叶支气管内含脂肪成分的病变,其中1例均匀脂肪密度的为脂肪瘤,1例软组织结节合并钙化灶的为错构瘤。结论:部分少见的气管支气管原发肿瘤临床和CT表现均有一定的特点,仔细分析有助于诊断和鉴别诊断。

Objective:To investigate the imaging diagnostic approaches of the rare primary tracheo-bronchial tumors.Methods:The clinical and CT manifestations of 16 cases with rare primary trachea-bronchial tumor were retrospectively analyzed.5 cases underwent plain CT scanning,7 cases had enhanced CT and 4 cases had both plain and enhanced CT scanning.The imaging features were correlated with surgery and pathology.Results:Of the 16 cases,7 cases were middle-aged(mean age=43.4y),which were diagnosed as adenoid cystic carcinoma,among which 6 cases manifested as broad bases intra-tracheal nodule and homogenous iso-attenuation;4 cases were diagnosed as mucoepidermoid carcinoma,mainly occurred in young patients(mean age=34.8y),located at lobar or segmental bronchus,the main CT manifestations were intra-luminal or intra-/extra-luminal solitary nodule/mass;2 cases were atypical carcinoid tumor,both of which were elderly(mean age=63y),both of the tumor located at right bronchus,showing as mass extending along the lumina,1 case manifested as typical"iceberg sign"with remarkable homogenous enhancement;1 case was diagnosed as sarcomatoid carcinoma,shown as intra-/extra-luminal solitary mass extending along the lumen with mild enhancement;2 cases had fat-containing lesion,1 case with lipoma shown as homogenous fat-density,the other one was hamartoma showing a soft tissue nodule with calcified foci.Conclusion:Certain CT and clinical characteristics could be revealed in some rare primary trachea-bronchial tumors,careful analysis is helpful in the diagnosis and differential diagnosis.Careful analysis helps to make diagnosis and differential diagnosis.