CAJ | 학술논문

目的探讨气管支气管树黏液表皮样癌(MEC)的CT表现,以提高对其诊断水平.方法回顾性分析经病理证实的24例气管支气管树MEC的CT、临床和病理学资料.结果 24例中主要临床表现有咳嗽、咯痰、发热、胸闷、气促、胸痛和咯血.19例为低度恶性型,5例为高度恶性型.病灶位于气管1例,主支气管6例,叶支气管12例,段及以下支气管5例.肿瘤呈无腔外浸润的边界清晰的腔内类圆形结节13例(位于叶支气管及以上气管)和条柱状3例(位于主支气管);呈非浸润性的边界清晰的腔内外类圆形结节、肿块6例,位于叶及以下支气管;呈浸润性的腔内外不规则肿块2例,均为高度恶性型.平扫12例,肿瘤均接近或等于肌肉组织密度,4例瘤内有钙化.增强扫描20例,1例因病灶小而观察不清,明显强化17例.20例有气管阻塞性改变.结论气管支气管树MEC多为低度恶性,好发于主、叶支气管,CT上多表现为边界清晰的气管腔内或腔内外非浸润性占位,增强后明显强化,部分可有肿瘤钙化.
목적 탐토기관지기관수점액표피양암(MEC)적CT표현,이제고대기진단수평.방법 회고성분석경병리증실적24례기관지기관수MEC적CT、림상화병이학자료.결과 24례중주요림상표현유해수、각담、발열、흉민、기촉、흉통화각혈.19례위저도악성형,5례위고도악성형.병조위우기관1례,주지기관6례,협지기관12례,단급이하지기관5례.종류정무강외침윤적변계청석적강내류원형결절13례(위우협지기관급이상기관)화조주상3례(위우주지기관);정비침윤성적변계청석적강내외류원형결절、종괴6례,위우협급이하지기관;정침윤성적강내외불규칙종괴2례,균위고도악성형.평소12례,종류균접근혹등우기육조직밀도,4례류내유개화.증강소묘20례,1례인병조소이관찰불청,명현강화17례.20례유기관조새성개변.결론 기관지기관수MEC다위저도악성,호발우주、협지기관,CT상다표현위변계청석적기관강내혹강내외비침윤성점위,증강후명현강화,부분가유종류개화.
Objective To explore the CT findings of mucoepidermoid carcinoma (MEC) of the tracheobronchial tree and improve the diagnostic accuracy. Methods The CT images, histopathological and clinical data in 24 patients with pathologically proved MEC of the tracheobroncbial tree were retrospectively analyzed. Results The clinical symptoms included cough, sputum, fever, wheezing, chest pain and hemoptysis. The patient was proved to be low-grade (n=19) and high-grade (n=5) MEC histopathologically. One lesion was located in trachea, 6 in main bronchus, 12 in lobar bronchus and 5 in segmental, subsegmental and distal bronchus. The tumor presented as no-invasive endotracheobronchial well-defined round-like nodule (n=13, locating in lobar and higher bronchus) and columnar sharp (n=3, locating in main bronchus), or intra-and-extraluminal well-defined round-like nodule or mass (n=6, locating in lobar and lower bronchus) and irregular mass with invasive pattern (n=2, high-grade type). The density of lesion was similar to the muscule and the calcification within lesion was showed in 4 patients on non-enhanced CT. The lesion had marked enhancement in 17 patients on enhanced CT. Obstructive changes were found in 20 patients. Conclusion MEC of the tracheobronchial tree is usually low-grade malignancy and locates in main and lobar bronchus with no-invasive well-defined airway mass, marked enhancement and calcification on CT.