Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, 555 University Ave., Toronto, ON M5G 1X8, Canada.
AJR Am J Roentgenol. 2010 Mar;194(3):772-8. doi: 10.2214/AJR.09.2490.
The purpose of this study was to evaluate the CT characteristics of lung nodules present at diagnosis of extrapulmonary malignancies in children.
We performed a retrospective analysis of CT images of children seen in our oncology service over a 6-year period. We included all children diagnosed with a non-CNS solid extrapulmonary malignancy or lymphoma who had also undergone chest CT at presentation. Images were reviewed for the presence of lung nodules; if present, the following nodular characteristics were recorded: sidedness, number, distribution, CT attenuation, shape, margins, calcification, and size. When available, pathology results were correlated with the nodules found on CT.
One hundred eleven infants and children (age range, 14 days-17 years 10 months; median age, 11 years 8 months) had lung nodules on CT. The nodules showed a variety of patterns, but the most common findings were bilateral lung nodules (71 of 111 patients), between two and 10 in number (60 patients), peripheral distribution (98 patients), < or = 5 mm (48 patients), oval shape (45 patients), solid attenuation (74 patients), smoothly marginated (91 patients), and noncalcified (107 patients). Twenty-seven patients underwent biopsy. Seventeen biopsies showed benign lesions and nine, malignant lesions; the results for the remaining biopsy were inconclusive. In the subgroup of lung nodules that underwent biopsy, none of the CT characteristics was able to differentiate benignity from malignancy.
Lung nodules in children with extrapulmonary malignancies showed a variety of patterns on CT. In the subgroup of lung nodules that underwent biopsy, none of the nodule features studied on CT reliably differentiated benignity from malignancy.
本研究旨在评估儿童肺外恶性肿瘤诊断时肺部结节的 CT 特征。
我们对我院肿瘤科 6 年来的 CT 图像进行了回顾性分析。纳入所有经组织学或细胞学证实的肺外实体恶性肿瘤或淋巴瘤患儿，且均行胸部 CT 检查。观察肺部结节的存在，如存在，记录结节的特征：位置、数量、分布、CT 衰减值、形态、边缘、钙化及大小。如有可能，将病理结果与 CT 上发现的结节进行比较。
111 例婴儿和儿童（年龄 14 天-17 岁 10 个月，中位年龄 11 岁 8 个月）在 CT 上发现有肺部结节。结节表现为多种形态，但最常见的表现为双肺结节（71/111 例），2-10 个结节（60 例），外周分布（98 例），<或=5mm（48 例），椭圆形（45 例），实性密度（74 例），边缘光滑（91 例），无钙化（107 例）。27 例行活检。17 例活检为良性病变，9 例为恶性病变，其余活检结果不确定。在接受活检的肺结节亚组中，CT 特征均无法区分良恶性。
儿童肺外恶性肿瘤的 CT 表现为多种结节形态。在接受活检的肺结节亚组中，研究的 CT 特征均无法可靠地区分良恶性。
