肺肉瘤样癌的CT表现

目的探讨原发性肺肉瘤样癌临床特征及多层螺旋CT的影像表现。方法回顾性分析43例经手术或活检病理证实为原发性肺肉瘤样癌患者的临床病理资料及CT表现。43例全部行胸部CT检查，其中30例行CT增强扫描。结朵43例中男性34例，女性9例，临床表现无特异性。CT主要表现为肺内单发肿块，发病时肿瘤最大径一般大干5cm，周围型（39例）多于中央型（4例），跨叶生长8例；边缘光滑或清楚；毛刺征、胸膜牵拉征少见：坏死、空洞及分叶、支气管截断多见，坏死边界不清，可见坏死内强化灶；肺门及纵隔淋巴结转移多为环形强化。结论肺肉瘤样癌体积较大并可跨叶生长，以膨胀生长为主：其“坏死内强化”具有一定的特征性。

CT Manifestations of Pulmonary Sarcomatoid Carcinoma

0bjective To investigate clinical features and multi-slice spiral CT manifestations of primary pulmonary sarcomatoid carcinoma.Methods The clinical and imaging data of forty-three patients with primary pulmonary sarcomatoid carcinoma which were confirmed by surgery or pathology were retrospectively reviewed.All of them undertook CT examinations and 30 of them undertook contrast-enhanced CT scanning.Results Of 43 patients,34 were male and 9 were female.There was no specific clinical features.CT images showed single mass in lung with the diameter universally more than 5cm.The peripheral PSC(39 cases) were more than the central bronchogenic PSC(4 cases),and the lesions of 8 cases crossed two or three lopes.The lesions had clear boundary and rarely showed spiculated sign and pleura dragging sign,but often showed necrosis,cavity and sublobe and the cutoff of bronchus.The necrosis had obscure boundary and showed enhanced focus.Metastatic lymph nodes in hilum or mediastinum were mostly circular enhanced.Conclusion Primary pulmonary sarcomatoid carcinoma is usually in large size,and can grow cross lobes,mainly in expansile growth.Enhanced focus in necrosis has certain characteristics.