气管支气管树腺样囊性癌MSCT表现

摘要

Objective:This study is to improves the understanding of adenoid cystic carcinoma (ACC) of the tracheobronchial tree by observing the multi-slice cornputed tomography (MSCT) features. Methods:The MSCT features of 19 cases with primary tra-cheobronchial ACC confirmed by histopathology were retrospectively analyzed. Results:Among the 19 cases, lesions were located in the trachea in seven cases, in the segmental and above segmental bronchi in 10 cases, in the peripheral lung in two cases. Intra-and ex-traluminal growth were observed in 15 cases (79%), whereas broad-based intraluminal lesions were exhibited in two cases (11%). Among the seven cases of tracheal ACC, the CT scans for five cases showed a notable tendency toward submucosal extension. Two cas-es manifested as a diffuse or circumferential wall thickening of the trachea, and the other three cases presented homogeneous mass fill-ing of the trachea with wall thickening. The 10 cases with bronchial ACC were manifested as intra-and extraluminal growth. Eight cas-es presented homogeneous polypoid growth toward the adjacent lumen, and seven cases presented extraluminal parts that were larger than the intraluminal parts. Among 13 contrast-enhanced examinations, three cases were without enhancement, five cases were slightly enhanced, four cases were moderately enhanced, and one case was highly enhanced. Conclusion:MSCT performances of ACC of the tracheo-bronchial tree possessed certain characteristics, such as broad-based mass, intra- and extraluminal growth, and diffuse wall thickening. CT can diagnose tumor malignancy, but the definitive diagnosis for ACC should depend on pathology.%目的：观察分析气管支气管树腺样囊性癌（adenoid cystic carcinoma，ACC）的MSCT表现，以期提高对该病的认识。方法：回顾性分析和总结天津医科大学肿瘤医院2004年4月至2013年4月经组织病理证实的19例原发气管支气管树腺样囊性癌的MSCT表现。结果：19例中气管病变7例，段及以上支气管病变10例，周围型病变2例；腔内外生长型15例（79%），腔内生长型2例（11%）。气管ACC有明显的沿气管黏膜下浸润延伸趋势，表现为气管壁弥漫环周增厚2例，移行状增厚3例；10例段及以上支气管ACC均表现为腔内外型肿物，8例病变相邻支气管腔内可见息肉样影隆起或突入，7例腔外部分大于腔内。13例增强检查中3例无强化，5例轻度强化，4例中度强化，1例明显强化。结论：气管支气管树腺样囊性癌MSCT表现具有一定特点，CT可定性诊断，但明确诊断需依靠病理。