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目的探讨纵隔类癌的组织来源、临床表现及诊治。方法对 6例病理证实的原发性纵隔类癌的临床、病理、影像学及随访情况进行分析 ,并对有关文献进行复习和总结。结果①临床无特异性表现 ,肿瘤较小时无症状 ,类癌综合征少见 ;②影像学可以发现病变 ,特别CT和MRI对肿瘤位置、大小、密度、边缘及周围结构关系、有否转移和复发显示良好 ;③诊断主要依靠病理学银染、电镜或免疫组化 ;④手术切除加放、化疗是最佳治疗方案。结论原发性纵隔类癌少见 ,可能源于胸腺组织 ,临床症状无特异 ,主要依据影像学发现病变 ,定性诊断依据病理 ,通过CT、临床、病理可推测预后。
Objective To investigate the origin, clinical manifestations, diagnosis and treatment of mediastinal carcinomas. Methods The clinical, pathological, imaging and follow-up of 6 cases of primary mediastinal carcinomas confirmed by pathology were analyzed. The related literatures were reviewed and summarized. Results ① There was no specific clinical manifestations, asymptomatic tumors were small, asymptomatic carcinoid syndrome; ② imaging can detect lesions, especially CT and MRI on tumor location, size, density, the relationship between the edge and the surrounding structure, whether the transfer and recurrence Showing good; ③ diagnosis mainly rely on pathological silver staining, electron microscopy or immunohistochemistry; ④ surgical resection plus radiotherapy, chemotherapy is the best treatment. Conclusions Primary mediastinal carcinoid tumors are rare and may originate from thymus tissue. The clinical symptoms are nonspecific. The lesions are mainly diagnosed by imaging. The qualitative diagnosis is based on the pathology. The prognosis can be estimated by CT, clinical and pathological findings.