空洞型肺转移瘤的CT表现及与原发灶病理类型的关系

目的　　探讨空洞型肺转移瘤的CT表现及其与原发灶病理类型的关系。方法　　报告空洞型肺转移瘤40例131枚,分析其CT表现并与原发灶病理类型进行对比。结果　　全部空洞瘤灶均与肺多发实性结节共存。共有泡样空洞41枚,不规则空洞33枚,囊样空洞26枚,小环形空洞3l枚。壁厚度均匀者61枚,不均匀者70 枚。瘤灶直径<15mm 者44 枚,15～25mm 者66枚,25～40mm者1枚,>40mm者4 枚。洞壁厚度<4mm者69枚,4～15mm者44枚,>15mm者18枚。空洞型瘤灶多见于腺癌(22例)与鳞癌(13例),二者在CT表现上各有一定特征。空洞型瘤灶的发生与其在肺内的部位无关。结论　　空洞型肺转移瘤的CT表现具有一定特点,并与原发灶病理类型有关。

Cavitary Pulmonary Metastases: CT Features and Their Correlation with the Pathology of the Primary Malignancy

To study CT features of cavitary pulmonary metastases and to investigate the possible relationship between CT features and the pathology of the primary lesions. CT findings of 131 cavitary metastatic nodules in 40 patients with pathologically-proved pulmonary metastases were retrospectively analyzed. A comparison between CT signs and the pathologic types of the primary tumors was made. Cavitary metastases and multiple solid nodules coexisted in all patients. Cavitary metastases presented as bubble (n=41), irregular (n=33), cystic (n=26) or small circular (n=31) cavities, with even (n=61) or uneven (n=70) thickness of the cavity wall. Of 131 cavitary nodules, diameter less than 15 mm was seen in 44, between 15–25 mm in 66, 25–40 mm in 17 and larger than 40 mm in 4 respectively. And the wall thickness of the cavity below 4 mm, between 4–15 mm and over 15 mm was respectively seen in 69, 44 and 18 metastatic nodules. Cavitary pulmonary metastases mainly occurred in patients whose primary malignancy was squamous cell carcinoma (n=13) or adenocarcinoma (n=22). Both squamous cell carcinoma and adenocarcinoma had its own CT characteristics. The occurrence of cavity bore no relationship to its site in the lung. Cavitary pulmonary metastases carries certain CT features and its occurrence is related to the pathologic type of the primary malignancy.