CAJ | 학술논문

目的：探讨涎腺淋巴上皮癌(lymphoepithelial carcinoma，LEC)的CT、MRI及病理学特点。方法：回顾性分析22例涎腺LEC患者的影像学资料及病理组织学表现，其中18例行CT平扫及增强扫描，4例行MRI平扫及增强扫描。结果：22例患者中共检出22个病灶，位于腮腺16例，颌下腺6例。边界清楚6例，边界不清16例。CT上密度均匀16例，不均匀2例，MRI上信号均匀4例，T1WI上为低信号， T2WI上呈稍高信号，增强扫描中度强化12例，明显强化10例。8例侵犯周围结构，10例颌下及颈动脉鞘区见肿大淋巴结。组织学均表现为肿瘤性上皮细胞伴淋巴细胞间质浸润及免疫组织化学CK阳性表达。结论：涎腺LEC的影像学表现具有一定的特征性，肿块常密度或信号均匀，增强扫描中度至明显强化，坏死较少见，多伴有同侧颈部淋巴结肿大。病理学上改变符合组织学特点和免疫组织化学检测，结合影像学CT、MRI的定位，排除鼻咽癌转移，即可诊断为原发性涎腺LEC。
목적：탐토연선림파상피암(lymphoepithelial carcinoma，LEC)적CT、MRI급병이학특점。방법：회고성분석22례연선LEC환자적영상학자료급병리조직학표현，기중18례행CT평소급증강소묘，4례행MRI평소급증강소묘。결과：22례환자중공검출22개병조，위우시선16례，합하선6례。변계청초6례，변계불청16례。CT상밀도균균16례，불균균2례，MRI상신호균균4례，T1WI상위저신호， T2WI상정초고신호，증강소묘중도강화12례，명현강화10례。8례침범주위결구，10례합하급경동맥초구견종대림파결。조직학균표현위종류성상피세포반림파세포간질침윤급면역조직화학CK양성표체。결론：연선LEC적영상학표현구유일정적특정성，종괴상밀도혹신호균균，증강소묘중도지명현강화，배사교소견，다반유동측경부림파결종대。병이학상개변부합조직학특점화면역조직화학검측，결합영상학CT、MRI적정위，배제비인암전이，즉가진단위원발성연선LEC。
Objective:To determine the CT, MRI and pathological features of salivary gland lymphoepithelial carcinoma (LEC). Methods:hTe CT and MRI ifndings of 22 patients with histologically proved salivary gland LEC were retrospectively reviewed. Eighteen patients underwent plain and enhanced CT scans, and four patients underwent plain and enhanced MR scans. Results:Salivary gland LECs were located in parotid gland in 16 patients and submandibular gland in six patients. Tumor margin was well-deifned in six cases, and ill-deifned in 16 cases. On CT scans, density was homogeneous in 16 cases, and heterogeneous in two cases. Signal intensity was homogeneous in all four cases underwent MR scans. Hypo-signal intensity on T1WI and slight hyper-signal intensity were found in all four patients. Moderate enhancement was found in 12 patients while intense enhancement was found in remaining 10 patients. Invasion to adjacent structures were found in eight patients. Enlarged lymph nodes were found in 10 patients. Pathology show epithelial cells of tumors with lymphocytic interstitial infiltration and immunohistochemical median to highly expression of CK. Conclusion:Salivary gland LECs have some distinct imaging features that are characterized as homogeneous masses with moderate to intense enhancement but with less necrosis, and unilateral draining lymphadenopathy are common. hTe pathological changes with the characteristics of histology and immunohistochemistry detection, combined with the position imaging CT, MRI, rule out Metastasis of nasopharyngeal cancer can be diagnosed as primary salivary gland LEC.