原发性肺肉瘤样癌的CT表现特征

摘要

目的 探讨原发性肺肉瘤样癌的CT表现特征.方法 回顾性分析14例经手术病理证实为原发性肺肉瘤样癌的CT表现.结果 14例中临床表现为胸痛、咳嗽6例,咳嗽伴痰中带血5例,胸闷气喘2例,无症状1例.14例均为肺内单发肿块,其中位于右上肺7例,右下肺1例;左上肺3例,左下肺3例.周围型11例,中央型3例;平扫肿块呈等低密度,肿块密度不均匀伴坏死12例,密度均匀2例;肿块边界光滑7例,肿块边界呈分叶状7例;瘤内空洞1例,瘤内点状钙化1例;胸膜侵犯5例,气胸1例,肝脏转移1例.增强后肿块周边呈斑片状或环状强化,中央强化不明显或不均匀斑片状强化.结论 原发性肺肉瘤样癌的CT表现为肺内单发肿块,多见于右肺上叶,密度不均,增强肿瘤周边呈斑片状或环形强化为特征.%Objective To investigate the CT characteristics of primary pulmonary sarcomatoid carcinoma (PSC). Methods CT characteristics of 14 cases with primary pulmonary saromatoid cacinoma confirmed by surgical pathology were analyzed retrospectively. Results Among the 14 cases, the clinical manifestations were chest pain and cough in 6 cases, cough with blood-stained sputum in 5 cases, chest tightness and asthma in 2 cases, and no symptoms in 1 case. All the 14 cases had solitary masses in the lung. Carcinoma of 7 cases located in the upper lobe of the right lung, and carcinoma of 1 case located in the inferior lobe of the right lung. Carcinoma of 3 cases was located in the upper lobe of the left lung, and 3 cases were found in the inferior lobe of the left lung. Eleven cases had peripheral tumors and 3 cases had central tumors. CT plain scan revealed an isodense mass. There were 12 cases with uneven mass density and necrosis, and 2 cases had uniform mass density. The smooth margin was identified in 7 masses, and ill-defined margin and lobulation was shown in 7 masses. Cavity was observed in 1 mass, and speckled calcification was seen in 1 mass. Pleural invasion and thickening was in 5 cases, pneumothorax occurred in 1 case, and there was 1 case of liver metastasis. Enhancement scan showed patchy or annular enhancement around the mass, and the central enhancement of the mass was not obvious or uneven patchy enhancement. Conclusions The CT characteristics of primary pulmonary sarcomatoid carcinoma are solitary masses in the lung, especially if the mass is located in the periphery of the upper lobe of the right lung with uneven density, and enhancement scan shows patchy or annular enhancement around the mass.