肺癌胰腺转移瘤的CT表现

目的探讨肺癌胰腺转移瘤的CT特征,提高对该病的认识,为更好的诊断提供参考。方法回顾性分析2010年2月至2022年12月经病理活检或CT随访确诊的肺癌胰腺转移瘤26例,总结其临床资料及CT表现。结果26例肺癌胰腺转移瘤患者中,原发性肺癌病理类型小细胞肺癌16例、腺癌7例、鳞癌3例。所有患者中单发结节型10例、多发型15例、胰腺弥漫增大型1例,共发现47枚转移灶。1例胰腺弥漫增大型占据胰腺头、体、尾部,其余46枚转移灶分别位于胰头16枚、胰体16枚、胰尾14枚。转移灶长径约0.4~12.7 cm,平均大小约(2.82±1.54)cm,其中形态规则40枚,7枚转移灶外形不规则或分叶状。平扫低密度30枚,等密度17枚;增强扫描肝动脉期显示环形强化20枚,整体强化27枚。静脉期轻度强化32枚,中度强化15枚,液化坏死5枚。所有病例均有胰腺外转移,1例远侧胰管扩张,1例周围血管侵犯。结论肺癌胰腺转移瘤具有一定的CT特征,结合原发肺癌病史,有助于明确诊断。

Objective To investigate the Computed tomography(CT)features of pancreatic metastases from lung cancer,improve the understanding of this disease,and to provide reference for better diagnosis.Methods The clinical data and CT findings of 26 patients with pancreatic metastases from lung cancer diagnosed by pathological biopsy or CT follow-up from February 2010 to December 2022 were retrospectively analyzed.Results Among 26 patients with pancreatic metastases from lung cancer,16 cases of primary lung cancer were small cell lung cancer,7 cases of adenocarcinoma were lung adenocarcinoma,and 3 cases were lung squamous cell carcinoma.Among all the patients,10 metastatic tumors were solitary nodular,15 metastatic tumors were multiple,and 1 metastatic tumor was diffusely enlarged pancreas.A total of 47 metastatic lesions were found.The diffuse enlargement of pancreas occupied the head,body,and tail of the pancreas in one case,and the remaining 46 metastases were located in the head of the pancreas,16 in the body of the pancreas and 14 in the tail of the pancreas.The long diameter of the metastases was about 0.4~12.7cm,with an average size of about 2.82±1.54cm,of which 40 were regular in shape and 7 were lobulated or irregular in shape.On plain scan,30 lesions had low density,and 17 lesions had iso-density.On enhanced scan,20 lesions had annular enhancement in the hepatic arterial phase,and 27 lesions showed overall enhancement.In the venous phase,32 lesions had mild enhancement,15 had moderate enhancement,and 5 had liquefaction necrosis.All cases had extra pancreatic metastasis,1 case had distal pancreatic duct dilation,and 1 case had peripheral vascular invasion.Conclusion Pancreatic metastases from lung cancer have certain CT features,which combined with the history of primary lung cancer,can help in better diagnosis.