文章摘要

肺炎型黏液腺癌的CT诊断价值

作者: 1吴婧, 2王兆宇, 3潘军平, 4黄勇, 5唐永强, 1卢铃铨
1 南京医科大学附属南京医院(南京市第一医院)放射科，南京 210006
2 浙江大学舟山医院病理科，浙江 舟山 316000
3 韶关曲江区人民医院放射科，广东 韶关 512000
4 山东省肿瘤医院放射科，济南 250000
5 第四军医大学第一附属医院(西京医院)，西安 710000
通讯: 卢铃铨 Email: njllq333@sina.com
DOI: 10.3978/j.issn.2095-6959.2017.10.020

摘要

目的：探讨肺炎型黏液腺癌(pneumonia type mucinous adenocarcinoma，PTMA)的多层螺旋CT(multi-slice CT，MSCT)征象，以提高对该病的诊断水平。方法：经手术病理或穿刺活检证实的91例黏液腺癌中，有36例为PTMA，55例结节型黏液腺癌。36例PTMA通过CT及病理对照，分析PTMA的CT特征性表现。结果：在36例PTMA病例中，伴周围边界清楚磨玻璃影(ground glass opacity，GGO)占94%；边缘膨隆或部分膨隆占100%；支气管“枯树枝”征占88.9%，20%伴有扩张，30.5%出现支气管远端闭塞；13例CT增强患者中100%出现不均匀强化且存在低密度区；出现空腔占66.7%，空洞占30.5%；63.9%病例伴有结节影，其中90%结节边缘光滑，形态规则，部分伴有周围GGO。仅有1例(2.8%)出现胸水，且抗炎治疗后吸收。叶间裂膨隆占80.6%；22.2%的病例见胸膜侵犯或淋巴结肿大或远处转移。结论：MSCT对PTMA诊断有重要作用。
关键词： 肺炎型黏液腺癌 CT 病理学

Value of CT diagnosis in pneumonia type mucinous adenocarcinoma

Authors: 1WU Jing, 2WANG Zhaoyu, 3PAN Junping, 4HUANG Yong, 5TANG Yongqiang, 5LU Lingquan
1 Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006
2 Department of Pathology, Zhoushan Hospital, Zhejiang University, Zhoushan Zhejiang 316000
3 Department of Pathology, People’s Hospital of Qujiang District of Shaoguan, Shaoguan Guangdong 512000
4 Department of Radiology, Shandong Tumor Hospital, Ji’nan 250000
5 Department of Pathology, First Affiliated Hospital of Fourth Military Medical University, Xi’an 710000, China

CorrespondingAuthor: LU Lingquan Email: njllq333@sina.com

DOI: 10.3978/j.issn.2095-6959.2017.10.020

Abstract

Objective: To investigate the multi-slice CT (MSCT) findings of pneumonia type mucinous adenocarcinoma (PTMA) in order to improve the diagnosis of this disease. Methods: Thirty-six cases of PTMA and 55 cases of nodular mucinous adenocarcinoma were found in 91 cases of mucinous adenocarcinoma proved by operation, pathology or biopsy. The CT features of 36 cases PTMA were studied according to comparing of CT and pathology. Results: In 36 cases of PTMA, with clear border ground glass opacity (GGO) accounted for 94%; the edge bulging or partly bulging accounted for 100%; bronchial “leafless tree sign” accounted for 88.9%, 20% with expansion, 30.5% with bronchial distal obstruction; 13 cases enhanced CT in 100% cases showed heterogeneous enhancement and low density area; “cavum sign” accounted for 66.7%, “cavity sign” for 30.5%; 63.9% cases with nodules, 90% nodules with smooth edges, regular shape, partly with ground glass. Only 1 patient (2.8%) developed pleural effusion and were absorbed after anti-inflammatory treatment. Interlobular fissure expansion accounted for 80.6%; pleural invasion, lymph node enlargement or distant metastasis was seen in 22.2% of cases. Conclusion: MSCT plays an important role in the diagnosis of PTMA.
Keywords： pneumonia type mucinous adenocarcinoma CT pathology

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