细支气管腺瘤/纤毛黏液结节性乳头状肿瘤的影像学表现及临床特征
Imaging and clinical features of bronchiolar adenoma/ciliated muconodular papillary tumor
刘统 1孟庆成1
作者信息
- 1. 450008 河南郑州,郑州大学附属肿瘤医院(河南省肿瘤医院)放射科
- 折叠
摘要
目的:探讨细支气管腺瘤/纤毛黏液结节性乳头状肿瘤的影像学表现和临床特征.方法:回顾性分析2018年9月-2023年1月在本院经病理证实的14例细支气管腺瘤/纤毛黏液结节性乳头状肿瘤患者的临床、病理及术前影像学资料(CT检查14例,PET-CT检查5例).对患者的基本信息、临床症状和病史、影像学特征(部位、直径、血管征和SUV等)及临床诊断结果进行总结和分析.结果:14例中,男6例,女8例;年龄32～73岁,中位年龄59.5岁.4例有临床症状,包括咳嗽、咳痰、胸部不适或痰中带血.主要CT表现如下:病灶长径5～30 mm,平均(14.1±6.7)mm;病灶主要位于肺下叶(10例),位于右肺8例;实性病灶5例、部分实性病灶7例、非实性病灶2例;边缘模糊者7例、边缘清晰者7例;血管征阳性10例;细支气管充气征阳性3例;空泡征阳性3例.术前CT有2例被诊断为肺恶性病变、12例被诊断为恶性暂不除外并均建议结合穿刺活检.PET-CT检查显示3例有代谢异常,SUVmax值为0.6～13.9 kBq/mL;2例代谢无明显异常.1例被诊断为恶性病变暂不除外,2例被诊断为肺恶性病变,2例被诊断为肺良性病变.结论:细支气管腺瘤/纤毛黏液结节性乳头状肿瘤CT及PET-CT 表现多样且无特异性的临床表现,部分病灶SUV值升高,故临床上极易将其误诊为肺部恶性病变,因此在临床工作中需提高对此病变的认识并做好鉴别诊断.
Abstract
Objective:To explore the imaging manifestations and clinical features of bronchiolar adenoma/ciliated muconodular papillary tumor(BA/CMPT).Methods:A retrospective analysis was conducted on the preoperative imaging and clinical-pathological data of 14 patients with pathologically confirmed BA/CMPT in our hospital from September 2018 to January 2023.All patients underwent CT scan and five patients underwent PET-CT examination.The patients'basic information,medical history and clinical symptoms,and imaging features of the lesions(location,length,vascular sign,SUV,etc.)and the preoperative diagnosis results were analyzed.Results:In 14 patients,6 were males and 8 were females,and the age were 32～73 years old with median of 59.5yrs.Four patients had clini-cal symptoms,including coughing,sputum production,chest discomfort and blood streaks in sputum.The main CT manifestations were as follows:the maximum diameter of the 14 lesions were 5～30mm with means of(14.1±6.7)mm;10 lesions were located in the lower lobe,8 were at the right lung;5 le-sions were solid,7 lesions were partially solid,and 2 lesions were not solid;7 lesions showed blurred edges,and 7 lesions showed clear edges;10 lesions showed vascular signs;3 lesions showed bronchiolar inflation sign;3 lesions showed vacuolar sign.Preoperative CT diagnosis:pulmonary malignant lesions in two cases,and inclusive diagnosis of malignant lesions with recommendation of puncture biopsy in 12 cases.PET-CT examination of five cases showed that metabolic abnormality was found in 3 cases with maximum standardized uptake values(SUVmax)of 0.6～13.9kBq/mL,and no significant metabo-lic abnormality was found in 2 cases.Among the five cases,one cases were diagnosed as suspicious ma-lignant lesions,two cases were diagnosed as malignant lung lesions,and two cases were diagnosed as benign lung lesions.Conclusion:CT and PET-CT manifestations of BA/CMPT are diverse and do not have typical clinical features.Elevated SUV values were found in a few cases,making it highly suscep-tible to misdiagnosis as pulmonary malignancy in clinical practice.Therefore,it is necessary to improve the comprehensive understanding of this disease and make differential diagnosis in clinical work.
关键词
细支气管腺瘤/纤毛黏液结节性乳头状肿瘤/体层摄影术,X线计算机/正电子发射体层摄影术Key words
Bronchiolar adenoma/Ciliated muconodular papillary tumor/Tomography,X-ray computed/Positron emission tomography引用本文复制引用
基金项目
河南省医学科技攻关计划省部共建重点项目(SBGJ202102057)
出版年
2024
NETL
NSTL
万方数据