摘要
目的探讨肺腺癌蜂房征的CT表现。方法搜集经穿刺或手术病理组织学证实为肺腺癌且具有符合蜂房征定义CT表现的33例患者的临床资料,观察肺癌主体病灶及蜂房征的部位、形态、大小,蜂房征所占比例,边缘有无分叶、毛刺,近端有无血管纠集,远端有无阻塞性肺炎及肺不张等,以及有无淋巴结或远处转移。结果单发32例,多发1例。具有蜂房征表现的肺腺癌病灶共44个,其中呈结节或肿块型30例41个病灶,包括纯磨玻璃结节2个,部分实性结节12个,实性结节或肿块27个;呈炎症型病灶3个。病灶分布:右上肺10例,右下肺9例,右中肺3例,左上肺2例,左下肺8例,双肺多发1例。结节型或肿块型病灶大小:最大5.4 cm,最小0.9 cm,平均2.7 cm。除此以外,其他恶性征象有分叶出现率77.3%(34/44),毛刺出现率36.4%(16/44),血管集束征出现率25.0%(11/44),远端阻塞性炎症或肺不张出现率22.7%(10/44),胸膜凹陷出现率34.0%(15/44);1例同时合并空泡征。病理结果:高-中分化9例,非高中分化24例,其中3例部分存在贴壁生长。结论蜂房征更多见于肿块或结节型肺腺癌,结合肺腺癌其他CT表现,可进一步提高肺腺癌诊断的正确性。
Objective This paper focuses on CT manifestations of pulmonary adenocarcinoma with the honeycomb sign.Methods Clinical data of 33 cases were collected in our hospital from 2012 to 2015. All the cases had lung adenocarcinoma proven by biopsy or surgical pathology,and furthermore,they showed the honeycomb sign on CT images. Analysis was done to observe the CT manifestations of the main lesion（ as well as the honeycomb sign in lung cancer） such as lesion location,shape,size,proportion of honeycombing,divided leaf emergence,burr,vascular bundle sign,distal obstruction of inflammation or lung atelectasis and pleural indentation. Results In 33 cases,32 cases were solitary and 1 case had multiple lesions. Performance of honeycomb lung adenocarcinomas has a total number of 44,and in which a nodule or mass type（ n = 30） 41 lesions,including 2 pure ground glass nodules,12 part solid nodules,27 solid nodules or masses,3 inflammatory lesions. Lesions location： 10 cases were located in the upper right lung,9 in the right lower lung,3 in the right middle lung,2 in the left upper lung,8 in the left lower lung,and only 1 case with multiple locations. Nodule or mass size： The size ranged from 0. 9cm to 5. 4cm with an average of 2. 7cm. In addition,other malignant signs including divided leaf emergence,burr,vascular bundle sign,distal obstruction of inflammation or lung atelectasis and pleural indentation were observed,and the rate was 77. 3%（ 34 /44）,36. 4%（ 16 /44）,25. 0 %（ 11 /44）,22. 7%（ 10 /44）,34. 0%（ 15 /44）,respectively; 1 case also had intercurrent vacuole sign. Pathological results： 9 cases had well-moderate differentiation,24 cases of non-well-moderate differentiation,of which 3 cases were proliferated along the wall. Conclusion Honeycomb syndrome is more common in the lung adenocarcinoma with masses or nodules. If these observations are combined with other CT findings of the lung adenocarcinoma,this can further improve the accuracy in diagnosis of lung adenocarcinoma.
出处
《临床放射学杂志》
CSCD
北大核心
2016年第12期1818-1821,共4页
Journal of Clinical Radiology
基金
江苏省卫生计生委基金资助项目(编号:H201509)
