Liu Ye, Tian Shu-Ping, Nie Yong-Kang, Zhao Shao-Hong, Xing Ning, Wu Chong-Chong, Jin Xin, Fu Yan-Ning
Department of Radiology,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China.
Universal View Medical Imaging Diagnostic Center,Beijing 100039,China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2022 Jun;44(3):433-439. doi: 10.3881/j.issn.1000-503X.14939.
Objective To improve the understanding and diagnostic accuracy of pulmonary mucoepidermoid carcinoma(PMEC) by analyzing the imaging and clinical characteristics.Methods The clinical and CT data of 27 cases of PMEC confirmed by histopathology in the First Medical Center of Chinese PLA General Hospital from January 2016 to December 2020 were retrospectively analyzed,including the location,size,margin,density,enhancement characteristics,accompanying signs,and pathological grade.Results The 27 cases included 6(6/27,22.2%) of large airway type,14(14/27,51.9%) of hilar type,and 7(7/27,26.9%) of peripheral type.The CT manifestations of 20 cases of large airway and hilar PMEC were soft-tissue nodules or mass with clear boundary in the lumen of the trachea and main bronchi,including 6 cases of mild enhancement,4 cases of moderate enhancement,5 cases of marked enhancement,and 5 cases of uneven enhancement.Three of the 20 cases showed calcification.The 7 cases of peripheral PMEC showed soft-tissue nodules or masses in the lungs,including 3 cases of mild enhancement,1 case of moderate enhancement,and 3 cases of marked enhancement. Obstructive pneumonia or atelectasis and bronchiectasis with mucus plug formation occurred in 16(16/27,59.3%) cases,lymph node metastasis in 9(9/27,33.3%) cases,and multiple organ metastasis in 8(8/27,29.6%) cases.Age(=-3.132,=0.005),enlarged lymph node (=9.281,=0.003),and distant metastasis(=7.816,=0.008) were statistically significant in the low-grade group and high-grade group. Conclusion PMEC have some unique imaging features,and recognizing these signs is conducive to the differential diagnosis and the improvement of the diagnostic accuracy.
目的 通过分析肺黏液表皮样癌（PMEC）的影像学及临床特征，提高对其的认识及诊断准确性。方法 回顾性分析2016年1月至2020年12月在中国人民解放军总医院第一医学中心经组织病理学确诊的27例PMEC的临床及CT资料，包括病变部位、大小、边缘、密度、强化特征、伴随征象及病理分级。结果 27例中大气道型6例（6/27，22.2%），肺门型14例（14/27，51.9%），外周型7例（7/27，26.9%）。20例大气道及肺门型PMEC的CT表现为气管及主支气管腔内边界清晰的软组织结节或肿块，其中轻度强化6例，中度强化4例，明显强化5例，不均匀强化5例，20例中有3例可见钙化。7例外周型PMEC表现为肺内软组织结节或肿块，其中轻度强化3例，中度强化1例，明显强化3例。16例（16/27，59.3%）出现阻塞性肺炎或肺不张及黏液栓形成的支气管扩张，9例（9/27，33.3%）出现淋巴结转移，8例（8/27，29.6%）出现多器官转移。低级别组和高级别组在年龄（=-3.132，=0.005）、肿大淋巴结（=9.281，=0.003）及远处转移（=7.816，=0.008）方面差异有统计学意义。结论 PMEC具有一些独特的影像学特征，认识这些征象有助于鉴别诊断并提高诊断准确性。
