| 囊腔型肺癌的临床病理与CT表现分析 |
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| 引用本文： | 蒙虹伽,陈小娟,黄俊杰,何晓雪,陈淮.囊腔型肺癌的临床病理与CT表现分析[J].CT理论与应用研究,2023,32(1):97-104. |
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| 作者姓名： | 蒙虹伽 陈小娟 黄俊杰 何晓雪 陈淮 |
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| 作者单位： | 1.广州医科大学, 广州 511495 |
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| 基金项目： | 广东省自然科学基金（基于机器学习的CT肺转移瘤早期诊断模型建立及疗效预测（2019A1515011382））。 |
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| 摘 要： | 目的：囊腔型肺癌是一种少见的、具有特殊形态学表现的肺癌，在影像学上尚未被充分认识，本研究通过分析其CT特征及临床病理，以提高对该类特殊类型肺癌的认识及诊断能力。方法：回顾性总结分析本院2015年1月至2021年6月期间确诊的囊腔型肺癌患者的临床信息、病理类型及CT图像特征。结果：病理类型：腺癌44例（86.27%），其中微浸润性腺癌7例（1 3.7 3%），浸润性腺癌3 5例（6 8.6 3%）（组织学类型：贴壁为主型1 1例（21.57%）、乳头状为主型8例（15.69%）、腺泡为主型15例（29.41%）且其中2例（3.92%）含微乳头成分占比大于20%,1例（1.96%）未分型），1例（1.96%）化疗后手术病理提示腺癌，1例（1.96%）淋巴结穿刺活检提示肺转移性腺癌；鳞癌5例（9.80%），其中角化性鳞状细胞癌3例（5.89%），非角化性鳞状细胞癌2例（3.92%）；大细胞癌1例（1.96%），高级别粘液表皮样癌1例（1.96%）。病灶以外周分布为主40例（80.30%）；平均直径为（4.7±2.7）cm，主体成分：囊腔伴磨玻璃成分20例（39.22%）、囊腔伴实性成分22例...
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| 关 键 词： | CT 肺癌 囊腔 |
| 收稿时间： | 2022-01-20 |
Clinicopathological and CT Findings of Cystic Lung Cancer |
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| Affiliation: | 1.Guangzhou Medical University, Guangzhou 511495, China2.Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China3.Department of Radiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China |
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| Abstract: | Objective: Cystic lung cancer is a rare type of lung cancer with special morphological manifestations on imaging that have not been completely recognized. This study aimed to improve the understanding and diagnosis of this lung cancer by analyzing its computed tomography (CT) features and clinicopathological findings. Methods: The clinical data, pathological types, and CT features of patients with cystic lung cancer who were diagnosed at our hospital between January 2015 and June 2021 were analyzed retrospectively. Results: We identified 44 cases (86.27%) of adenocarcinomas; these included 7 (13.73%) and 35 (68.63%) cases of microinvasive adenocarcinomas and invasive adenocarcinomas, respectively. Regarding the histological type, 11 (21.57%), 8 (15.69%), and 15 (29.41%) cases were of the adjoint, papillary, and acinar types, respectively. Two cases (3.92%) contained micropapillary components that accounted for more than 20% . Furthermore, one case (1.96%) was not classified, and in another case (1.96%), pathological examination after chemotherapy suggested an adenocarcinoma. Lymph node biopsy in one case (1.96%) suggested a metastatic lung adenocarcinoma. Squamous cell carcinoma was observed in five cases (9.80%); these included three (5.89%) and two (3.92%) cases of keratinizing and non-keratinizing squamous cell carcinomas, respectively. A large cell carcinoma and a high-grade mucoepidermoid carcinoma were observed in one case each (1.96%). A peripheral distribution was observed in 40 cases (80.30%). The mean diameter was 4.7± 2.7 cm. A cystic cavity with ground glass, cystic cavity with solid components, and cystic cavity with mixed components were observed in 20 (39.22%), 22 (43.14%), and 9 (17.65%) cases, respectively. According to the Mario classification, 24 (47.06%), 8 (15.69%), 9 (17.65%), and 10 (19.61%) cases were of types I, II, III, and IV, respectively. The cyst wall was uneven in 42 cases (82.35%); furthermore, a lobular lesion edge and the burr sign were observed in 28 (54.90%) and 14 (27.45%) cases, respectively. Moreover, 33 cases (64.71%) showed a separation within the lesions, while 36 cases (70.59%) had a smooth inner lesion wall. Regarding the relationship with the pleura, pleural traction and closed pleura were observed in 24 (47.06%) and 11 (21.57%) cases, respectively. The peripheral blood vessels passed through the lesion in eight cases (15.69%) and adhered closely to the edge of the lesion in 16 cases (31.37%). The surrounding bronchi passed through the lesion in eight cases (15.69%) and moved toward the edge of the lesion in 21 cases (41.18%). Conclusion: Cystic lung cancer has certain features on CT that can allow its suggestive diagnosis. |
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