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目的:探讨肺肉瘤样癌的CT影像特点及其诊断价值。方法:回顾性分析22例肺肉瘤样癌的临床资料和CT影像特点。结果:22例肺肉瘤样癌中,周围型19例(86.3%),中央型3例(13.7%);均表现为肺内肿块或结节,密度大部分不均匀,1例(4.5%)钙化,5例(22.7%)空洞。17例(77.3%)呈类圆形,3例(13.7%)呈楔形,1例(4.5%)呈葫芦状,1例(4.5%)呈条状。19例(86.3%)有分叶,7例(31.8%)有毛刺,3例(13.7%)有胸膜凹陷征。3例(13.7%)支气管狭窄伴阻塞性肺不张,1例(4.5%)纵隔大血管被侵犯,12例(54.5%)侵犯邻近胸膜或胸壁,15例(68.1%)肺门淋巴结增大,14例(63.6%)纵隔淋巴结增大。转移到同侧肺2例(9.1%%),骨1例(4.5%)。结论:肺肉瘤样癌以周围型为主,肿块较大,密度不均匀,易侵犯邻近胸膜或胸壁,伴肺门、纵隔淋巴结转移。
Objective: To investigate the features and diagnostic value of CT images of pulmonary sarcomatoid carcinoma. Methods: The clinical data and CT features of 22 cases of pulmonary sarcomatoid carcinoma were analyzed retrospectively. Results: In 22 cases of pulmonary sarcomatoid carcinoma, there were 19 cases (86.3%) in peripheral type and 3 cases (13.7%) in central type. Most of the tumors showed nodules or nodules in the lung, Calcification, 5 cases (22.7%) empty. Seven cases (77.3%) were round, three cases (13.7%) were wedge-shaped, one case (4.5%) had a gourd-like shape and one case (4.5%) had a strip shape. Nineteen (86.3%) had lobulation, seven (31.8%) had burr, and three (13.7%) had pleurodesis. Three cases (13.7%) had bronchial stenosis with obstructive atelectasis, one case (4.5%) of the mediastinal vessels were invaded, 12 cases (54.5%) infiltrated the adjacent pleura or chest wall, and 15 cases (68.1%) had an enlarged hilar lymph node , Mediastinal lymph nodes increased in 14 cases (63.6%). Two cases were transferred to ipsilateral lung (9.1 %%) and one case was bone (4.5%). CONCLUSIONS: Sarcomatoid carcinoma of the lung is mainly peripheral type with larger mass and uneven density. It is easy to invade adjacent pleural or chest wall, with hilar and mediastinal lymph node metastasis.