原发性肺透明细胞癌的影像学表现

[目的]探讨原发性肺透明细胞癌的X线与CT特征。[方法]报道经手术与病理证实的原发性肺透明细胞癌5例，并结合文献病例对其X线与CT表现进行了分析。[结果]影像学上该病主要表现周围性结节或肿块病变(3例，占60％)，少数可呈多发结节(本组1例，占20％)．早期可表现小片状阴影(本组1例．占20％)或小结节．后者边缘呈毛刺状．类似早期腺癌，但肿块较大时多数边缘光滑．少见棘状突起、空洞及肺门纵隔淋巴结转移(本组未见)．随访肿块增大。[结论]原发性肺透明细胞癌仅有相对影像学特征．术前查痰、纤支镜活检与穿刺活检可能误诊为鳞癌或腺癌．确诊依赖于手术病理检查或胸腔镜活检。

Imaging Manifestations of Primary Clear Cell Carcinoma in the Lung

ObjectiveTo study the X-ray and CT features of primary clear cell carcinoma (PCC) in the lung.Five cases with PCC of the lung were confirmed by operation and pathological examination, their X-ray and CT manifestations were analyzed retrospectively in combination with those cases reported on literatures.The main manifestation of imaging in PCC appeared as peripheral nodules or masses (3/5, 60%), a few lesions exhibited multiple nodules (1/5,20%). Imaging at the early stage showed small stretches of shadow (1/5,20%) or tiny nodules with coarse spiculate margin,which were alike to early adenocarcinoma. When masses of tumor grew larger , smooth margins were found in most of them , spinous process, cavity and hilar mediastinal lymph nodes metastasis were seldom seen (none in our cases). Masses were shown enlarged during follow-up.[Conclusions]PCC in the lung may be misdiagnosed as aquamous cell carcinoma or adenocarcinoma, if limited atypical imaging features are relied upon as well as preoperative examination of sputum cytology ,fibrotic bronchoscopy and percutaneous needle biopsy are usually used. Accurate diagnosis should depend on surgical pathology or thoracoscopic biopsy.