小细胞肺癌的螺旋CT表现特征

目的 明确未治疗小细胞肺癌的螺旋CT表现特征，以利于提高CT诊断的准确性。资料与方法 搜集未经治疗且行胸部螺旋CT增强扫描并经病理证实的小细胞肺癌32例，观察其胸部螺旋CT表现特征，结合其他临床资料进行分期。结果 32例小细胞肺癌中，局限性病变6例(18．8％)，广泛播散性病变26例(81．2％)；中心型27例(84．4％)，周围型5例(15．6％)。3l例(96．9％)表现为肺内肿块或结节，其中肿块密度均匀29例(90．6％)，钙化及空洞各1例。19例(59．4％)发现支气管狭窄，16例(50％)伴阻塞性肺炎，10例(31．3％)伴阻塞性肺不张。14例(43．8％)纵隔大血管被包埋或侵犯。31例(96．9％)肺门淋巴结增大，25例(78．1％)纵隔淋巴结增大。转移至对侧肺5例(15．6％)、神经系统5例(15．6％)、腹部脏器(肝、肾上腺)4例(12．5％)、骨骼3例(9．4％)。结论 小细胞肺癌以中心型为主，呈实体性生长，CT上肿块密度较均匀，易侵犯支气管及纵隔大血管，伴肺门、纵隔淋巴结转移。

Spiral CT Features of Small Cell Lung Cancer

Objective To describe helical CT appearances of untreated small cell lung cancer (SCLC) and to improve imaging diagnosis of the disease.Materials and Methods Thoracic enhanced helical CT findings of 32 patients with pathologically-proved untreated SCLC were analyzed. Combined with the clinical information, staging of the tumor was made.Results Of 32 cases, the lesion was localized in 6 (18.8%) and extensively disseminated in 26 (81.2%). Central type was seen in 27 (84.4%) and peripheral type in 5 cases (15.6%). In 31 cases (96.9%), the lesion presented as an intra-pulmonary mass or nodule. The mass density was homogeneous in 29 (90.6%) and calcification and cavity was seen in one case each. Bronchial stenosis was found in 19 cases (59.4%), of which obstructive pneumonia was accompanied in 16 and atelectasis in 10 cases. Involvement or encasement of great vessels in mediastinum occurred in 14 cases (43.8%). Hilar and mediastinal lymphadenopathy was seen in 31 (96.9%) and 25 cases (78.1%), respectively. Metastases were found in the contralateral lung (n=5), central nervous system (n=5), abdominal organs (n=4) and bone (n=3).Conclusion SCLC is mainly of central type, growing in solid fashion. On CT scan, the tumor has homogeneous density. SCLC is apt to invade bronchus, great vessels, and both hilar and mediastinal lymph nodes.