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目的 总结小儿胸膜肺胚细胞瘤(pleuropulmonaryblastoma,PPB)的CT表现特点,以提高早期诊断率。方法 10例小儿PPB均经手术及病理证实,全部行CT平扫,其中7例同时行增强扫描。结果 10例中发生于左肺9例,右肺1例。按Dehner分型:Ⅱ型2例,Ⅲ型8例。病变直径5~16cm,其中>8cm者7例。CT平扫表现: 2例为囊实性混杂密度占位,囊内均含多少不等气体。8例为类圆形或形态不规则软组织密度占位,其内见不规则略低密度区;增强扫描实性部分有不同程度的增强,低密度区不强化。合并胸腔积液、肺不张各4例,肋骨破坏及胸壁软组织肿物2例。结论小儿PPB是儿童期少见的胚胎性恶性肿瘤,CT扫描为早期诊断及观察病变变化的首选方法。
Objective To summarize the CT features of pediatric pleuropulmonary blastoma (PPB) in order to improve the early diagnosis rate. Methods All 10 cases of pediatric PPB were confirmed by operation and pathology. CT scan was performed in all of them. Seven of them underwent enhanced scan at the same time. Results of 10 cases occurred in the left lung in 9 cases, 1 case of right lung. According to Dehner classification: type Ⅱ in 2 cases, type Ⅲ in 8 cases. Lesions diameter 5 ~ 16cm, of which> 8cm in 7 cases. CT scan performance: 2 cases of cystic solid mixed density of space, the capsule contains a number ranging from gas. 8 cases of round or irregular shaped soft tissue density of space occupancy, which see the irregular slightly lower density area; enhance the real part of the enhanced scan with varying degrees of enhancement, low-density area is not enhanced. Pleural effusion, atelectasis in 4 cases, rib destruction and chest wall soft tissue mass in 2 cases. Conclusion Pediatric PPB is a rare embryonic malignancy in childhood. CT scan is the first choice for early diagnosis and observation of pathological changes.