肺肉瘤样癌的CT表现

目的分析7例经病理证实的肺肉瘤样癌(PSC)的CT表现与临床资料,以提高对该病的认识。方法回顾性分析7例PSC的CT表现,所有病例均行CT平扫及增强扫描,分析病灶发生的部位、形态、强化形式与周围侵犯及转移等。结果 7例PSC均为单发,左肺4例,右肺3例;6例为周围型,1例为中央型。病灶平扫为软组织密度,其中6例密度不均匀,可见片状低密度坏死区;增强扫描5例呈厚环状强化,1例呈片絮状强化,1例病灶较小呈轻度均匀强化。所有病例免疫组织化学见CK(+)与Vim(+)。结论 PSC CT表现有一定的特点,周围型常表现为较大的肿块,易侵犯胸壁,增强扫描多呈厚环状强化,病灶常可见片状低密度坏死区,确诊需依靠病理学检查。

CT Findings of Pulmonary Sarcomatoid Carcinoma

Objective To discuss CT features and clinical data of pulmonary sarcomatoid carcinoma so as to improve its recognition.Methods CT findings of 7 cases with pulmonary sarcomatoid carcinoma were retrospectively analyzed,including the location,contour,contrast enhancement pattern,surrounding invasion and metastasis.All the patients received CT plain scanning and enhanced CT scanning.Results All the 7 cases had single mass: 4 in left lung,3 in right lung;6 were peripheral type,1 was central type.The plain CT showed soft tissue mass with uneven density.6 of them had heterogeneous enhancement with weak or unremarkable enhancement at central area.5 cases showed thick ring enhancement,1 case showed lamellar and floccular enhancement,only one small lesion demonstrated mild homogeneous enhancement.On immunohistochemical examination,CK and Vim are positive in all the 7 cases.Conclusion There are certain CT characteristics in lung sarcomatoid carcinoma.The peripheral types always show large masses and heterogeneous ring enhancement with central patchy necrosis.However,definite diagnosis depends on pathology.