CT findings of surgically resected large cell neuroendocrine carcinoma of the lung in 38 patients
CT findings of surgically resected large cell neuroendocrine carcinoma of the lung in 38 patients
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DOI：
10.2214/ajr.182.1.1820087
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发表时间：
2004-01-01
影响因子：
5
通讯作者：
Moriyama, N
中科院分区：
文献类型：
--
作者：
Oshiro, Y;Kusumoto, M;Moriyama, N
客观的。我们试图评估手术切除的肺大细胞神经内分泌癌的 CT 特征。材料和方法。对1993年至2000年在同一机构接受原发性肺癌手术切除并初步诊断为低分化非小细胞肺癌、小细胞癌、类癌和大细胞神经内分泌癌的所有患者进行组织学回顾。 43 名患者的结果经过组织学重新分类并确认为大细胞神经内分泌癌。两名观察员对 38 名患者的 CT 扫描进行了评估。 结果。在 38 名患者中，发现了 6 个中心肿瘤和 32 个周围肿瘤，直径范围为 12 至 92 圈（平均值 +/- SD，32 +/- 19 mm）。没有一个肿瘤在肿块或结节中出现空气支气管征或钙化。在 19 名进行薄层 CT 扫描的患者中，14 名（74%）显示肿瘤-肺界面清晰，5 名（26%）显示界面不明确。 15 次扫描（79%）发现了分叶状，6 次扫描（32%）发现了明显的毛刺。在对比增强 CT 扫描中，不均匀增强的肿瘤似乎比均匀增强的肿瘤 (25 ± 10 mm；p < 0.001) 更大 (51 +/- 18 mm)。组织病理学检查显示，28例CT增强患者中有20例出现肉眼坏死，CT扫描增强不均匀的原因被确定为瘤内坏死。所有 28 名患者均存在多处显微镜下坏死。结论。大细胞神经内分泌癌通常表现为边界清楚的分叶状肿瘤，没有空气支气管征或钙化。在大直径大细胞神经内分泌癌中观察到的不均匀强化（由坏死引起）在小直径（< 33 mm）大细胞神经内分泌癌中不一定明显，即使肿瘤含有坏死。
OBJECTIVE. We sought to assess the CT features of surgically resected large cell neuroendocrine carcinoma of the lung.MATERIALS AND METHODS. The cases of all patients who underwent surgical resection for primary lung cancer in a single institution from 1993 to 2000 and who received an initial diagnosis of poorly differentiated non-small cell lung carcinoma, small cell carcinoma, carcinoid tumor, and large cell neuroendocrine carcinoma were histologically reviewed. The findings for 43 patients were histologically reclassified and confirmed as large cell neuroendocrine carcinoma. The CT scans available for 38 patients were evaluated by two observers.RESULTS. In the 38 patients, six central tumors and 32 peripheral tumors, with diameters ranging from 12 to 92 turn (mean +/- SD, 32 +/- 19 mm), were identified. None of the tumors had air bronchograms or calcification in the mass or nodule. Of the 19 patients with thin-section CT scans, 14 (74%) showed the tumor-lung interface as well defined and five (26%) showed the interface to be ill defined. Lobulation was identified on 15 scans (79%) and spiculation was evident on six scans (32%). On contrast-enhanced CT scans, inhomogeneously enhanced tumors appeared to be larger (51 +/- 18 mm) than homogeneously enhanced tumors (25 10 mm; p < 0.001). At histopathologic examination, gross necrosis was noted in 20 of 28 patients who had undergone contrast-enhanced CT, and the cause of inhomogeneous enhancement on CT scans was determined to be intratumoral necrosis. Multiple microscopic necroses were present in all 28 patients.CONCLUSION. Large cell neuroendocrine carcinoma usually appears as a well-defined and lobulated tumor with no air bronchograms or calcification. The inhomogeneous enhancement (caused by necrosis) seen in large cell neuroendocrine carcinomas with large diameters is not necessarily apparent in small-diameter (< 33 mm) large cell neuroendoctine carcinomas, even if the tumor contains necrosis.