摘要
目的：探讨肺大细胞癌（LCLC）的CT表现。方法：回顾分析经手术病理证实的LCLC 15例的CT表现；10例采用常规CT；5例采用多层螺旋CT（MSCT）检查。结果：15例LCLC均为周围型，肿块多位于肺外围周边部，肿块平均4.5cm×5.5cm，肿块呈圆形、类圆形或欠规则形；13例边缘大部分光滑，浅分叶，周边少许小棘状突起，其密度欠均匀；2例边缘光滑，密度均匀；1例肿块内见多发细砂粒样钙化灶；1例形成厚壁空洞；1例形成薄壁空洞，见典型“空气半月征”；9例增强后肿块实质部分欠均匀轻中度强化，2例较均匀强化，1例环形强化，3例MSCT增强后60s肿块边缘及实质内见点状血管样强化；10例纵隔或同侧肺门淋巴结肿大；4例肿块侵犯胸膜，2例见胸膜凹陷征；MPR可以准确显示肿块的空间特征，准确了解肿块周围肺野及胸膜的关系。结论：CT特别是MSCT平扫及增强扫描，结合多平面重组（MPR）对LCLC的诊断具有重要价值。
Abstract
Objective: To explore CT features of large cell lung carcinoma(LCLC). Methods: CT findings in 15 cases of LCLC confirmed by surgery and pathology were retrospectively analyzed. Imaging were obtained by whole body CT in 10 cases and multi-slice spiral CT(MSCT) in the others. Results: The lesions were all presented as peripheral. Most of them were located in peripheral areas with a mean size of 4.5cm×5.5cm, which presented as round, oval or irregular in shape. The features of shallow lobulation, smooth margin, spicule-like process and heterogeneous density existed in 13 cases, and smooth margin homogenous density in 2 cases. 1 case showed internal grit-like calcification, 1 case showed thick-wall cavities and 1 case showed thin-wall with typical “air-crescent sign”. After contrast moderately heterogeneous enhancement of solid portion existed in 9 cases, homogenous enhancement in 2 cases and ring-shaped enhancement in 1 case. Three cases demonstrated punctiform vascular-like enhancement in the edge and solid portion after 60 seconds enhanced MSCT. Lymph node enlargement in mediastinum or hilum of the same side in 10 cases, pleural involed in 4 cases, “pleural indentation sign” existed in 2 cases. Multiple planar reconstruction(MPR) could exactly display the mass spatial characteristic and relationship with normal lung field and pleura. Conclusion: Plain and enhanced CT(especially MSCT) with MPR were valuable methods to the diagnosis of LCLC.
关键词
肺肿瘤 /
癌 /
大细胞 /
体层摄影术 /
X线计算机
Key words
lung neoplasms /
carcinoma /
large cell /
tomography /
X-ray computed
张海深;王 勇;钟 涛;王志芳;魏 民;黄平波.
肺大细胞癌的CT诊断价值[J]. 中国临床医学影像杂志. 2007, 18(6): 415-418
ZHANG Hai-shen;WANG Yong;ZHONG Tao;WANG Zhi-fang;WEI Min;HUANG Ping-bo.
CT diagnostic value of large cell lung carcinoma[J]. Journal of China Clinic Medical Imaging. 2007, 18(6): 415-418
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