原发性肺肉瘤样癌CT表现.docVIP

原发性肺肉瘤样癌CT表现 　　【中图分类号】R445 【文献标识码】A 【文章编号】1672－3783(2011)09－0272－01 　　【摘要】目的：分析原发性肺肉瘤样癌的CT表现。方法：回顾分析14例原发性肺肉瘤样癌患者临床资料及CT征象。结果：肺内肿块均为单发。右肺8例（57.14%），左肺6例（42.29%）；中心型3例（21.43%），周围型11例（78.57%）。12例病理结构均为梭形细胞与上皮细胞混合构成，2例为棱形细胞癌，l例为肺母细胞瘤。10例肿瘤形态规则，边界欠光滑，见不同程度分叶征、毛刺等征象，4例肿瘤形态规则，边界清楚。5例肿瘤相邻肺组织可见密度均匀磨玻璃影和纤维索条状影；病灶直径平均（4.8±1.3）cm。肿块呈软组织实性低密度影，密度不均匀，5例内有出血坏死灶。9例行增强扫描显示肿块均呈周边厚度不均的环形强化，内部无明显强化或呈不均匀斑片状“雪花样”强化。3例周围型PSC伴邻近胸膜或胸壁侵犯，肋骨骨质破坏。5例周围型和1例中心型可见肺门、纵隔淋巴结肿大，1例周围型伴有同侧胸腔少量积液。结论：PSC诊断CT表现具有一定特点，必要是行增加扫描，有助于临床诊断与鉴别诊断。? 　　【关键词】肉瘤样癌；肺肿瘤；CT? 　　The CT sign of pulmonary sarcomatoid carcinoma ? 　　LI Zhan_jun,GAO Jie_bing ,BAO Shi_liang ? 　　【Abstract】Objective To analyse the CT sign of pulmonary sarcomatoid carcinoma. Method Review clinical data and CT signs of 14 cases pulmonary sarcomatoid carcinoma. Results Pulmonary mass were single. Right lung in 8 cases (57.14%), left lung in 6 cases (42.29%); 3 cases (21.43%)were central-type, 11 cases (78.57%)were peripheral type. 12 cases of pathological structure of spindle cells and epithelial cells were mixed composition, 2 cases of prismatic cell carcinoma, l cases of pulmonary blastoma. 10 cases of tumor shape rules, the border less smooth, see varying degrees of lobulation, burrs and other signs, 4 tumors form of rules, clear boundary. Five cases of lung cancer can be seen adjacent uniform ground-glass density and fiber cable strip film; average diameter of lesions (4.8 ± 1.3) cm. Solid tumors, soft tissue density shadow, uneven density, 5 cases within bleeding and necrosis. 9 cases showed enhanced scan shows mass of uneven thickness around the ring enhancement, no enhancement within or showed heterogeneous patchy snowflake-like enhanced. Three cases of peripheral PSC with adjacent pleural or chest wall invasion, rib bone destruction. Five cases and one case of peripheral central type visible hilar and mediastinal lymph nodes, 1 case of peripheral associated with ipsilateral pleural effusion. Conclusion PSC has certain performance char