肺淋巴上皮瘤样癌CT表现

目的 探讨肺淋巴上皮瘤样癌(LELC)的CT表现.方法 回顾性分析244例经病理证实的肺LELC的CT表现.结果 244例LELC中,中央型132例(132/244,54.10％),周围型112例(112/244,45.90％);肿瘤最大径1.2～13.1 cm,平均(5.42±2.64)cm;结节型49例(49/244,20.08％),肿块型195例(195/244,79.92％);169例(169/244,69.26％)边界清晰,183例(183/244,75.00％)见分叶征,104例(104/244,42.62％)病灶边缘见毛刺;184例(184/244,75.41％)病灶紧贴纵隔,111例(111/244,45.49％)见“类胸膜尾征”改变.CT平扫158例(158/244,64.75％)病灶密度均匀,增强后中度强化160例(160/223,71.75％),145例(145/193,75.13％)呈渐进强化,108例(108/193,55.96％)动脉期病灶内见血管受侵变细和异常细小杂乱的血管影,81例(81/193,41.97％)动脉期病灶内见血管包埋征.185例(185/244,75.82％)见支气管包埋和/或闭塞.124例(124/244,50.82％)病灶周围见磨玻璃密度影,81例(81/244,33.20％)间质增厚,132例(132/244,54.10％)伴阻塞性肺炎或肺不张.167例(167/244,68.44％)肺门和/或纵隔淋巴结肿大.结论 右肺中叶、两肺下叶纵隔胸膜旁肿块,边界清、浅分叶,伴类胸膜尾征、增强动脉期血管包埋征、周围肺区磨玻璃密度影及网格增粗影和淋巴结肿大是肺LELC的相对特征性CT表现.