肺腺鳞癌的影像学表现和病理对照研究

目的探讨肺腺鳞癌影像学表现是否具有特殊性;瘤内的腺癌、鳞癌成分与Ｘ线表现及预后的关系。方法复习经手术切除、病理确诊为腺鳞癌者５１例,５２个病灶。全部病例均有正侧位胸片,ＣＴ２３例,ＭＲＩ６例。按照镜下腺癌成分含量分为＜４０％、４０％～６０％、＞６０％三组。结果（１）腺鳞癌的影像学表现：中央型３例;周围型４８例,占９４．１％。肿瘤直径２～１５ｃｍ,平均５．７ｃｍ。均呈分叶状、边缘光整１９例,占３９．６％;边缘不光整但无明显毛刺１８例（１９个病灶）,占３７．５％;有毛刺１４例,占２９．２％;偏心空洞８例,占１５．７％;胸膜皱缩１２例,占２５．０％。（２）瘤内成分含量与Ｘ线表现的关系：部位、边缘、密度、胸膜皱缩在三组之间差异无显著性。结论本组结果表明,肺腺鳞癌以周围型多见,肿瘤无特异性Ｘ线表现;腺癌成分含量与Ｘ线表现和预后无明显关系。

Adenosquamous carcinoma of the lung. A radiologic and pathologic study

OBJECTIVE: To study if there are characteristic radiologic features of adenosquamous carcinoma (ASC) of the lung and correlations of histo-pathologic components with radiologic findings and prognosis. METHODS: Fifty one pathologicall confirmed ASC cases (52 foci) were reviewed. All had chest radiographs, CT scans were available in 23 cases and MRI in 6 cases. These cases were subdivided into three groups according to the amount of adenocarcinoma component on microscopic manifestations: less than 40%, 40%-60%, and more than 60%. RESULTS: (1) Radiologic findings: In three cases, the tumor was of central type and in 48 cases (94.1%) of peripheral type. The size of tumor varied from 2 to 15 cm in diameter (mean, 5.7 cm). All the peripheral tumors were lobulated. In 19 cases (39.6%) the tumors were well demarcated, but poorly defined in 18 cases (19 foci) (37.5%) and spiculated in 14 cases (29.2%). Eccentric cavities with thickened wall were seen in 8 cases (15.7%) and pleural tag in 12 cases (25%). (2) Correlations between the amount of adenocarcinoma component and radiologic features: There were no statistically significant differences among the three groups with regard to tumor location, margin, and pleural tag. CONCLUSION: The radiologic findings of ASC are not specific; the most common finding is a peripheral mass. The amount of adenocarcinoma component is not significantly related with the radiologic features and prognosis.