原发性肺淋巴上皮瘤样癌的CT表现及文献复习

目的 探讨原发性肺淋巴上皮瘤样癌（LELC）的CT表现及鉴别诊断。方法 回顾性分析我院经手术病理证实的8例原发性肺LELC的临床病理及CT资料，并复习相关文献。结果 CT主要表现为单发的类圆形肿块，中央型1例，周围型7例；其中右肺5例，左肺3例；直径2.0～7.3cm，平均直径(4.1±1.6)cm；边界清楚，密度多均匀，4例边缘呈浅分叶状，1例伴血管包埋征，6例伴有纵膈及肺门淋巴结肿大。增强扫描，本组8例均表现为轻度或中度不均匀强化，2例伴小斑片状液化坏死。结论 原发性肺LELC的CT表现有一定特征性，但单凭CT诊断仍有一定困难，最终确诊还需依靠手术病理及免疫组化分析。

CT findings and literature review of primary pulmonary lymphoepithelioma-like carcinoma

Objective To investigate the CT features and differentiation of primary pulmonary lymphoepithelioma-like carcinoma (LELC). Methods The clinicopathology and CT data of 8 cases of primary pulmonary LELC confirmed by operation and pathology were retrospectively analyzed. Results 8 cases of primary pulmonary LELC mainly manifested as single round mass on CT images, 1 central tumor and 7 peripheral tumors. Among them 3 cases occurred in left lobe and 5 cases in right lobe. Eight tumors with diameters ranging from 2.0 to 7.3cm and average diameter (4.1±1.6) cm. CT findings of pulmonary LELC consisted of well-defined border, uniform density, superficial lobulation (4 cases), vascular or bronchial encasement (1 case), and lymphadenopathy in mediastinum or hilar (6 cases). On contrast-enhanced scanning, 8 patients had tumors with mild or moderate inhomogeneous enhancement, and 2 of them showed small plaque liquefaction necrosis. Conclusion Primary pulmonary LELC has certain CT characteristics, but it is still difficult to diagnose through CT alone. The final diagnosis should depend on surgical pathology and immunohistochemical analysis.