前纵隔神经内分泌肿瘤的CT表现

CT Findings of Anterior Mediastinal Neuroendocrine Tumor

目的:对前纵隔神经内分泌肿瘤的CT影像表现进行分析归纳。方法:回顾性研究福建医科大学附属泉州第一医院诊疗过的10例神经内分泌肿瘤患者的CT影像资料,术后均经病理证实为前纵隔神经内分泌肿瘤,总结该病CT影像特点。结果:10例患者中,女2例,男8例,平均年龄60.1岁,30%有胸痛,30%有咳嗽咳痰,其余无特殊症状。其中大细胞癌2例、小细胞癌2例、不典型类癌6例。CT上为前上纵隔体积巨大占位,呈软组织密度影,最大直径为9.1cm,3例出现钙化,6例出现坏死,较大的病灶表现出侵袭性,4例累及邻近血管,6例累及周围胸膜,增强检查呈中度或明显强化,强化不均匀,7例瘤内可见细小血管强化影,6例合并纵隔多发淋巴结转移,3例发生远处转移。结论:前纵隔神经内分泌肿瘤常见于中老年男性,具有体积大、易坏死、明显侵袭性、淋巴结转移等恶性肿瘤表现,其中瘤内细小血管强化影对神经内分泌肿瘤具有一定的提示意义,但确诊仍需结合病理检查结果。

Objective:To analyze and summarize the CT findings of anterior mediastinal neuroendocrine tumors.Methods:CT imaging data of 10 patients with neuroendocrine tumor treated in Quanzhou First Hospital Affiliated to Fujian Medical University were retrospectively studied.All patients were pathologically confirmed as anterior mediastinal neuroendocrine tumor after operation.Results:There were 2 females and 8 males,with an average age of 60.1 years.30%had chest pain,30%had cough and sputum,and the rest had no special symptoms.There were 2 cases of large cell carcinoma,2 cases of small cell carcinoma and 6 cases of atypical carcinoid.CT for the former on a huge mediastinal volume in soft tissue density,maximum diameter of 9.1cm,3 cases with calcification,6 cases with necrosis,larger lesions showed invasive,4 cases of adjacent blood vessels,around 6 cases involving pleura,the enhancement test was moderate or obvious reinforcement,strengthening uneven,7 cases of adenoma small blood vessels can be seen in the shadow,6 patients had multiple mediastinal lymph node metastases,and 3 patients had distant metastases.Conclusions:Anterior mediastinal neuroendocrine tumors are common in middle-aged and elderly men,with large size,easy necrosis,obvious invasion,lymph node metastasis and other malignant tumor manifestations.The enhancement of intratumoral small vessels has certain suggestive significance for neuroendocrine tumors,but the diagnosis still needs to be combined with pathological examination results.